PDF(Pubmed)
Abstract：
OBJECTIVE: This study aims to compare the outcomes of immediate (followed by closed-incision negative-pressure therapy use) versus delayed ORIF in patients with Schatzker type IV-VI TPFs.
METHODS: A prospective study of patients undergoing ORIF between January 2018 and December 2019 was performed. The inclusion criteria were patients (>18 years) with a closed fracture sent to the emergency room (ER) within 24 h of injury. All the patients underwent preoperative image evaluation. Two senior orthopedic trauma surgeons evaluated the soft tissue condition in the ER by 5P\'s of the compartment syndrome, judging the timing of the operation of definitive ORIF. Group 1 (n = 16) received delayed ORIF. Group 2 (n = 16) received immediate ORIF and ciNPT use. Patient follow-up occurred after 2 and 6 weeks and 3, 6, and 12 months after surgery. The assessments included the time to definitive fixation, the length of hospital stay, the time to bone union, surgical site complications, and reoperation within 12 months. A universal goniometer was used to measure the postoperative 3 m, 6 m, and 12 m ROM.
RESULTS: The patient demographics were similar between the groups (p > 0.05). Group 2 displayed significantly a shorter time to definitive fixation (5.94 ± 2.02 vs. 0.61 ± 0.28, p < 0.0001) and hospital stay (14.90 ± 8/78 vs. 10.30 ± 6.78, p = 0.0016). No significant difference was observed in the time to bone union, surgical site complication incidence, and reoperation rates (p > 0.05). Flexion and flexion-extension knee ROM were demonstrated to be significantly improved in Group 2, 3, 6, and 12 months postoperatively (p < 0.0001).
CONCLUSIONS: In this study, early ORIF and ciNPT use resulted in a shorter hospital length of stay, a reduced time to early active motion of the knee, and improved knee ROM. These results suggest that early ORIF with ciNPT for Schatzker type IV-VI TPFs is safe and effective in some patients. However, further research to confirm these findings across larger and more diverse populations is needed.
METHODS: A prospective study of patients undergoing ORIF between January 2018 and December 2019 was performed. The inclusion criteria were patients (>18 years) with a closed fracture sent to the emergency room (ER) within 24 h of injury. All the patients underwent preoperative image evaluation. Two senior orthopedic trauma surgeons evaluated the soft tissue condition in the ER by 5P\'s of the compartment syndrome, judging the timing of the operation of definitive ORIF. Group 1 (n = 16) received delayed ORIF. Group 2 (n = 16) received immediate ORIF and ciNPT use. Patient follow-up occurred after 2 and 6 weeks and 3, 6, and 12 months after surgery. The assessments included the time to definitive fixation, the length of hospital stay, the time to bone union, surgical site complications, and reoperation within 12 months. A universal goniometer was used to measure the postoperative 3 m, 6 m, and 12 m ROM.
RESULTS: The patient demographics were similar between the groups (p > 0.05). Group 2 displayed significantly a shorter time to definitive fixation (5.94 ± 2.02 vs. 0.61 ± 0.28, p < 0.0001) and hospital stay (14.90 ± 8/78 vs. 10.30 ± 6.78, p = 0.0016). No significant difference was observed in the time to bone union, surgical site complication incidence, and reoperation rates (p > 0.05). Flexion and flexion-extension knee ROM were demonstrated to be significantly improved in Group 2, 3, 6, and 12 months postoperatively (p < 0.0001).
CONCLUSIONS: In this study, early ORIF and ciNPT use resulted in a shorter hospital length of stay, a reduced time to early active motion of the knee, and improved knee ROM. These results suggest that early ORIF with ciNPT for Schatzker type IV-VI TPFs is safe and effective in some patients. However, further research to confirm these findings across larger and more diverse populations is needed.
摘要：
目的：本研究旨在比较SchatzkerIV-VI型TPFs患者即刻（随后使用闭合切口负压治疗）与延迟ORIF的结局。
方法：对2018年1月至2019年12月接受ORIF的患者进行了一项前瞻性研究。纳入标准是闭合性骨折患者（>18岁）在受伤后24小时内被送往急诊室（ER）。所有患者均行术前影像评估。两位资深骨科创伤外科医生通过5P的骨筋膜室综合征评估ER的软组织状况，判断最终ORIF的运行时间。第1组(n=16)接受延迟ORIF。第2组(n=16)立即接受ORIF和ciNPT使用。患者在术后2周和6周以及术后3、6和12个月进行随访。评估包括确定固定的时间，住院时间,骨头愈合的时间，手术部位并发症,并在12个月内再次手术。使用通用测角仪测量术后3m，6米,和12米ROM。
结果：两组患者的人口统计学相似（p>0.05）。第2组显示明确固定的时间明显较短（5.94±2.02vs.0.61±0.28，p<0.0001）和住院时间（14.90±8/78vs.10.30±6.78，p=0.0016）。骨愈合时间没有观察到显著差异，手术部位并发症发生率，再次手术率(p>0.05)。术后第2、3、6和12个月，屈伸膝关节ROM显著改善（p<0.0001）。
结论：在这项研究中，早期使用ORIF和ciNPT导致住院时间缩短，缩短了膝盖早期主动运动的时间，和改善膝盖ROM。这些结果表明，早期ORIF与ciNPT用于SchatzkerIV-VI型TPFs在某些患者中是安全有效的。然而,需要进一步的研究来证实这些发现在更大和更多样化的人群中.
方法：对2018年1月至2019年12月接受ORIF的患者进行了一项前瞻性研究。纳入标准是闭合性骨折患者（>18岁）在受伤后24小时内被送往急诊室（ER）。所有患者均行术前影像评估。两位资深骨科创伤外科医生通过5P的骨筋膜室综合征评估ER的软组织状况，判断最终ORIF的运行时间。第1组(n=16)接受延迟ORIF。第2组(n=16)立即接受ORIF和ciNPT使用。患者在术后2周和6周以及术后3、6和12个月进行随访。评估包括确定固定的时间，住院时间,骨头愈合的时间，手术部位并发症,并在12个月内再次手术。使用通用测角仪测量术后3m，6米,和12米ROM。
结果：两组患者的人口统计学相似（p>0.05）。第2组显示明确固定的时间明显较短（5.94±2.02vs.0.61±0.28，p<0.0001）和住院时间（14.90±8/78vs.10.30±6.78，p=0.0016）。骨愈合时间没有观察到显著差异，手术部位并发症发生率，再次手术率(p>0.05)。术后第2、3、6和12个月，屈伸膝关节ROM显著改善（p<0.0001）。
结论：在这项研究中，早期使用ORIF和ciNPT导致住院时间缩短，缩短了膝盖早期主动运动的时间，和改善膝盖ROM。这些结果表明，早期ORIF与ciNPT用于SchatzkerIV-VI型TPFs在某些患者中是安全有效的。然而,需要进一步的研究来证实这些发现在更大和更多样化的人群中.
