■儿科患者的肱骨头骨坏死最常见于有潜在血红蛋白病的患者,接触慢性皮质类固醇,或创伤后。这项研究的目的是进行系统评价,评估患病率,临床特征,儿童肱骨头骨坏死的治疗。
■PubMed,OvidMEDLINE,和Scopus用术语“骨坏死,\"\"无血管坏死,\"\"儿科,2024年1月10日的“和”肱骨近端“。共筛选了218项研究,对74项研究的合格性进行了评估.包括有关小儿肱骨头骨坏死的患病率和/或管理的研究。系统评价是根据系统评价和荟萃分析指南的首选报告项目进行的。
■12项研究符合纳入标准:4项回顾性病例系列,三个前瞻性案例系列,一项回顾性队列研究,一项回顾性病例对照研究,和三个病例报告。大多数研究(67%)讨论了化疗引起的肱骨头坏死。共发现77例(106名肩部)肱骨头骨坏死。在检查高危人群(潜在血红蛋白病或接受化疗)的8项研究中,肱骨头骨坏死的总体患病率为2%。关节内注射类固醇,物理治疗,和活动修改是有效的保守管理策略。此外,核心减压和半髋关节置换术是手术治疗的选择。
■肱骨头骨坏死的患病率较低,即使在有相关医疗条件的高危人群中。已经描述了各种保守和手术治疗方案,但是没有对这些模式进行比较评估。
■IV.
UNASSIGNED: Humeral head
osteonecrosis in the pediatric patients most often occurs in patients with underlying hemoglobinopathies, exposure to chronic corticosteroids, or after trauma. The purpose of this study was to perform a systematic
review evaluating the prevalence, clinical characteristics, and management of humeral head
osteonecrosis in the pediatric population.
UNASSIGNED: PubMed, Ovid MEDLINE, and Scopus were screened with the terms \"osteonecrosis,\" \"avascular necrosis,\" \"pediatric,\" and \"proximal humerus\" on January 10, 2024. A total of 218 studies were screened, and 74 studies were evaluated for eligibility. Studies that reported on the prevalence and/or management of pediatric humeral head osteonecrosis were included. The systematic
review was conducted according to the Preferred Reporting Items for Systematic
Review and Meta-Analyses guidelines.
UNASSIGNED: Twelve studies met inclusion criteria: four retrospective case series, three prospective case series, one retrospective cohort study, one retrospective case-control study, and three case reports. A majority of the studies (67%) discussed chemotherapy-induced osteonecrosis of the humeral head. A total of 77 patients (106 shoulders) with humeral head
osteonecrosis were identified. The overall prevalence of osteonecrosis of the humeral head across eight studies examining at-risk populations (underlying hemoglobinopathies or undergoing chemotherapy) was 2%. Intra-articular steroid injections, physical therapy, and activity modification are effective conservative management strategies. Additionally, core decompression and hemiarthroplasty are surgical treatment options.
UNASSIGNED: The prevalence of osteonecrosis of the humeral head is low even among at-risk populations with associated medical conditions. A variety of conservative and surgical treatment options have been described, but no comparative evaluations of these modalities has been conducted.
UNASSIGNED: IV.