PDF(Pubmed)
Abstract：
UNASSIGNED: Capitellum and trochlea fractures, also referred to as coronal shear fractures of the distal humerus, are infrequent yet challenging intra-articular fractures of the elbow. There are a variety of surgical approaches and fixation methods with often variable outcomes. This systematic review investigates interventions, outcomes and complications of capitellum and trochlea fractures.
UNASSIGNED: A systematic review of studies published in MEDLINE, EMBASE, Web of Science and Cumulative Index to Nursing and Allied Health literature (CINAHL) was conducted to assess the clinical outcomes of capitellum and trochlea fractures managed surgically. Data on patient demographics, surgical approach, implant usage, postoperative outcomes and complications were compiled.
UNASSIGNED: Forty-one studies met the inclusion criteria with a total of 700 patients. Surgical interventions primarily utilized either the lateral (79%) or antero-lateral (15%) approaches with headless compression screws as the most common fixation method (68%). Clinical outcomes were measured using the Mayo Elbow Performance Index (MEPI) with a mean score of 89.9 (±2.6) and the DASH score with a mean of 16.9 (±7.3). Elbow range of motion showed a mean flexion of 126.3° (±19.4), extension of 5.71° (±11.8), pronation of 75.23° (±12.2), and supination of 76.6° (±9.8). The mean flexion-extension arc was 113.7° (±16.9), and the mean pronation-supination arc was 165.31° (±9.41). Complications occurred in 19.8% of cases, with re-interventions required in 8.3% of cases, mainly due to symptomatic implants and elbow stiffness requiring surgical release. Other complications included implant removal (10.4%), overall reported stiff elbows (6%), nerve palsies (2%), non-union (1.5%), and infection (1.2%).
UNASSIGNED: The treatment of capitellum and trochlea fractures yields satisfactory outcomes but has a considerable rate of complications and reoperations primarily due to symptomatic implants and elbow stiffness. There is noteworthy variability in the achieved range of motion, suggesting unpredictable outcomes. Deficits in functionality and range of motion are common after surgery, especially with more complex injury patterns.
UNASSIGNED: A systematic review of studies published in MEDLINE, EMBASE, Web of Science and Cumulative Index to Nursing and Allied Health literature (CINAHL) was conducted to assess the clinical outcomes of capitellum and trochlea fractures managed surgically. Data on patient demographics, surgical approach, implant usage, postoperative outcomes and complications were compiled.
UNASSIGNED: Forty-one studies met the inclusion criteria with a total of 700 patients. Surgical interventions primarily utilized either the lateral (79%) or antero-lateral (15%) approaches with headless compression screws as the most common fixation method (68%). Clinical outcomes were measured using the Mayo Elbow Performance Index (MEPI) with a mean score of 89.9 (±2.6) and the DASH score with a mean of 16.9 (±7.3). Elbow range of motion showed a mean flexion of 126.3° (±19.4), extension of 5.71° (±11.8), pronation of 75.23° (±12.2), and supination of 76.6° (±9.8). The mean flexion-extension arc was 113.7° (±16.9), and the mean pronation-supination arc was 165.31° (±9.41). Complications occurred in 19.8% of cases, with re-interventions required in 8.3% of cases, mainly due to symptomatic implants and elbow stiffness requiring surgical release. Other complications included implant removal (10.4%), overall reported stiff elbows (6%), nerve palsies (2%), non-union (1.5%), and infection (1.2%).
UNASSIGNED: The treatment of capitellum and trochlea fractures yields satisfactory outcomes but has a considerable rate of complications and reoperations primarily due to symptomatic implants and elbow stiffness. There is noteworthy variability in the achieved range of motion, suggesting unpredictable outcomes. Deficits in functionality and range of motion are common after surgery, especially with more complex injury patterns.
摘要：
■Capitellum和滑车骨折，也被称为肱骨远端冠状剪切骨折，很少见但具有挑战性的肘关节内骨折。有多种手术方法和固定方法，通常结果可变。本系统综述调查了干预措施，头动脉和滑车骨折的结果和并发症。
■对MEDLINE上发表的研究的系统评价，EMBASE,进行了WebofScience和护理和相关健康文献累积指数（CINAHL），以评估手术治疗的头大骨折和滑车骨折的临床结果。患者人口统计数据，手术方法,植入物的使用,收集术后结局和并发症.
■41项研究符合纳入标准，共700名患者。手术干预主要利用侧面（79％）或前侧面（15％）方法和无头压紧螺钉作为最常见的固定方法（68％）。使用MayoElbow性能指数（MEPI）测量临床结果，平均得分为89.9（±2.6），DASH得分平均为16.9（±7.3）。肘部运动范围显示平均屈曲126.3°（±19.4），延伸5.71°(±11.8),内旋75.23°(±12.2),旋起76.6°(±9.8)。平均屈伸弧度为113.7°(±16.9),平均内旋弧为165.31°(±9.41)。并发症发生在19.8%的病例中,8.3%的病例需要重新干预，主要是由于有症状的植入物和需要手术释放的肘部僵硬。其他并发症包括植入物移除（10.4%），整体报告肘部僵硬(6%)，神经麻痹（2%），非工会（1.5%），和感染（1.2%）。
■头颅骨折和滑车骨折的治疗结果令人满意，但并发症和再次手术的发生率相当高，主要是由于有症状的植入物和肘部僵硬。在实现的运动范围内存在值得注意的可变性，暗示不可预测的结果。功能和活动范围的缺陷在手术后很常见，尤其是更复杂的伤害模式。
■对MEDLINE上发表的研究的系统评价，EMBASE,进行了WebofScience和护理和相关健康文献累积指数（CINAHL），以评估手术治疗的头大骨折和滑车骨折的临床结果。患者人口统计数据，手术方法,植入物的使用,收集术后结局和并发症.
■41项研究符合纳入标准，共700名患者。手术干预主要利用侧面（79％）或前侧面（15％）方法和无头压紧螺钉作为最常见的固定方法（68％）。使用MayoElbow性能指数（MEPI）测量临床结果，平均得分为89.9（±2.6），DASH得分平均为16.9（±7.3）。肘部运动范围显示平均屈曲126.3°（±19.4），延伸5.71°(±11.8),内旋75.23°(±12.2),旋起76.6°(±9.8)。平均屈伸弧度为113.7°(±16.9),平均内旋弧为165.31°(±9.41)。并发症发生在19.8%的病例中,8.3%的病例需要重新干预，主要是由于有症状的植入物和需要手术释放的肘部僵硬。其他并发症包括植入物移除（10.4%），整体报告肘部僵硬(6%)，神经麻痹（2%），非工会（1.5%），和感染（1.2%）。
■头颅骨折和滑车骨折的治疗结果令人满意，但并发症和再次手术的发生率相当高，主要是由于有症状的植入物和肘部僵硬。在实现的运动范围内存在值得注意的可变性，暗示不可预测的结果。功能和活动范围的缺陷在手术后很常见，尤其是更复杂的伤害模式。
