soft tissue coverage

软组织覆盖率
  • 文章类型: Journal Article
    目的:面部血管肉瘤很少见,但由于其起源于血液或淋巴管的支持组织,因此存在重大的治疗挑战。实现肿瘤疗效和美学结果之间的最佳平衡需要多学科的方法,特别是在需要根治性R0切除的情况下。延误经常发生,尤其是在组织病理学检查期间,在明确的病理发现之前,这会使原发性塑料重建复杂化。
    方法:要解决此问题,我们介绍了一例使用猪源脱细胞真皮基质进行临时软组织覆盖的病例,作为面部血管肉瘤的可行选择.这在冷冻切片有丧失关键解剖结构的风险且术中诊断不可行的情况下特别有用。这种方法在诊断阶段允许令人满意的伤口覆盖和肉芽形成。为肿瘤可管理的情况和功能康复铺平道路。
    结论:在罕见和复杂情况的肿瘤手术中,用猪来源的脱细胞真皮基质临时覆盖软组织是一种有价值的选择。
    OBJECTIVE: Angiosarcomas of the face are rare but present significant treatment challenges due to their origin in the supportive tissues of blood or lymphatic vessels. Achieving optimal balance between oncological efficacy and aesthetic outcomes requires a multidisciplinary approach, particularly in cases where radical R0 resection is necessary. Delays often occur, especially during histopathological examinations, which can complicate primary plastic reconstruction before definitive pathological findings.
    METHODS: To address this issue, we present a case with the use of porcine-derived acellular dermal matrix for temporary soft tissue coverage as a viable option in a case of angiosarcoma of the face. This is particularly useful in situations where frozen sections risk the loss of critical anatomical structures and intraoperative diagnosis is not feasible. This approach allowed for satisfactory wound coverage and granulation during diagnostic phases, paving the way for oncologically manageable situations and functional rehabilitation.
    CONCLUSIONS: Temporary soft tissue coverage with porcine-derived acellular dermal matrix is a valuable option in tumor surgery of rare and complex situations.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Journal Article
    深动脉穿支(PAP)皮瓣为手部和上肢重建提供了良好的选择。质量可靠,口径,大腿后内侧的穿孔器数量支持带长蒂的大皮瓣。PAP皮瓣已广泛应用于乳房再造,尽管由于皮下组织的体积和厚度,其在四肢的使用速度较慢。作者讨论了薄皮瓣的演变以及我们对薄超薄PAP皮瓣在上肢重建中的应用。
    The profunda artery perforator (PAP) flap provides a good option for hand and upper extremity reconstruction. The reliable quality, caliber, and number of perforators in the posteromedial thigh support large flaps with long pedicles. The PAP flap has been widely used for breast reconstruction, although its use in the extremities has been slower to catch on due to the bulk and thickness of the subcutaneous tissue. The authors discuss evolution of thin flaps and our application of the thin and superthin PAP flap for upper extremity reconstruction.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • 文章类型: Journal Article
    严重的软组织损伤和真皮的破坏需要整形重建治疗。对于多患者或无法进行大型重建手术的患者,使用真皮替代品,例如具有分层厚度皮肤移植物(STSG)的胶原蛋白-弹性蛋白基质(CEM),而不是局部或游离皮瓣手术,可能是一个有效和容易的治疗选择。我们旨在调查和比较使用CEM加STSG的成功缺损重建的结果和率,使用一步方法(同时进行CEM和STSG)或两步方法(CEM和伤口负压治疗(NPWT),进行二次STSG移植)。
    单中心,我们对接受CEM治疗的患者进行了回顾性随访研究.伤口已经用覆盖CEM的STSG移植治疗(MatriDerm,MedSkinSolutionsDr.SuwelackAG,德国)。在选定的患者群体中,以前用常规方法进行伤口闭合的尝试失败了。这通常会导致皮瓣手术。
    总的来说,纳入46例患者(平均年龄60.9±20.0岁),共有49个伤口。我们分析了38例不需要皮瓣覆盖的伤口患者;18例患者接受了一步方法,20例患者接受了两步方法。这些患者的平均随访时间为22±11.5个月,一名患者失去随访。总的来说,29(78.4%)伤口保持闭合。没有成功愈合的伤口与合并症有关,比如糖尿病,酒精滥用和吸烟。使用一步法,采用两步法闭合13个(76.5%)伤口和16个(80.0%)伤口,实现了长期缺损覆盖.然而,在伤口愈合障碍的发生率方面,一步法或两步法没有统计学显著差异.
    使用CEM加STSG在38个复杂伤口中实现伤口闭合,而11个伤口需要二次皮瓣覆盖。在无皮瓣的伤口中,一步法与两步法之间无统计学显著差异.使用简单的缺陷重建算法,我们成功使用CEM+STSG治疗复杂伤口.
    UNASSIGNED: Severe soft tissue damage with destruction of the dermis requires plastic reconstructive treatment. For multimorbid patients or patients unable to undergo major reconstructive surgery, use of dermal substitutes, such as a collagen-elastin matrix (CEM) with a split-thickness skin graft (STSG), instead of local or free flap surgery, may be a valid and easy treatment option. We aimed to investigate and compare the outcomes and rate of successful defect reconstruction using CEM plus STSG, using either a one-step approach (simultaneous CEM and STSG) or a two-step approach (CEM and negative wound pressure therapy (NPWT), with secondary STSG transplantation).
    UNASSIGNED: A single-centre, retrospective follow-up study of patients who had received CEM was conducted. Wounds had been treated with an STSG transplantation covering a CEM (MatriDerm, MedSkin Solutions Dr. Suwelack AG, Germany). Previous attempts at wound closure with conventional methods had failed in the selected patient population, which would usually have resulted in flap surgery.
    UNASSIGNED: Overall, 46 patients were included (mean age 60.9±20.0 years), with a total of 49 wound sites. We analysed 38 patients with wounds that did not require flap coverage; 18 patients received the one-step approach and 20 patients received the two-step approach. The mean follow-up in these patients was 22±11.5 months, and one patient was lost to follow-up. Overall, 29 (78.4%) wounds remained closed. Wounds which did not successfully heal were related to comorbidities, such as diabetes, alcohol misuse and smoking. Using the one-step approach, long-term defect coverage was achieved in 13 (76.5%) wounds and 16 (80.0%) wounds were closed using the two-step approach. However, there was no statistically significant differences between the one- or two-step approaches regarding the rate of development of a wound healing disorder.
    UNASSIGNED: Wound closure was achieved in 38 complex wounds using CEM plus STSG, while 11 wounds needed secondary flap coverage. In the flap-free wounds, there were no statistically significant differences between the one-step versus two-step approach. Using a simple defect reconstruction algorithm, we successfully used CEM plus STSG to treat complex wounds.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • 文章类型: Journal Article
    背景:与闭合性骨折相比,开放性胫骨骨折(OTF)的发病率和并发症风险大大增加。导致发病的最显著的OTF并发症通常被认为是骨折相关感染(FRI)。2016年9月,坦佩雷大学医院(TAUH)推出了基于BOAST4指南的OTF治疗方案。这项研究的目的是调查OTF治疗方案实施前后的结果。
    方法:从2007年5月1日至2021年5月10日,使用来自TAUH患者记录数据库的精选数据进行了一项回顾性队列研究。对于OTF患者,我们收集了描述性信息,FRI和骨不连的已知危险因素,骨固定方法,可能的软组织重建方法,有关内固定时间和软组织覆盖的信息,和主要操作的时间。作为结果措施,我们收集了有关FRI的信息,由于不联合而再次手术,襟翼失效,和二次截肢。然后,我们比较了在TAUH实施OTF治疗方案前后的并发症发生率。
    结果:在预定义排除之后,共纳入203例OTF患者.其中,在实施OTF治疗方案之前治疗141例,之后治疗62例。方案前方案组的FRI率明显高于方案组(20.6%vs1.6%,p=0.0015)。由于骨不连导致的再手术的发生率在方案前组中也显着较高(27.7%vs9.7%,p=0.0054)。根据多变量分析,在不同手术中进行的明确固定和软组织覆盖是FRI和由于骨不连而再次手术的独立危险因素.
    结论:实施后,在研究期间,基于BOAST4的OTF治疗方案降低了在TAUH治疗的OTF患者由于骨不连导致的FRI和再手术率.我们,因此,建议在治疗OTF患者的所有主要创伤中心实施此类治疗方案。此外,我们还建议将复杂OTF患者从缺乏提供基于BOAST4治疗的先决条件的医院立即转诊至专业中心.
    BACKGROUND: Open tibia fracture (OTF) causes a considerable increase in morbidity and risk for complications compared to closed fractures. The most significant OTF complication leading to morbidity is commonly considered to be fracture-related infection (FRI). In September 2016, Tampere University Hospital (TAUH) introduced a treatment protocol for OTFs based on the BOAST 4 guideline. The aim of this study is to investigate the outcomes before and after implementation of the OTF treatment protocol.
    METHODS: A retrospective cohort study was conducted using handpicked data from the patient record databases of TAUH from May 1, 2007, to May 10, 2021. For patients with OTF, we collected descriptive information, known risk factors for FRI and nonunion, bony fixation method, possible soft tissue reconstruction method, information about the timing of internal fixation and soft tissue coverage, and timing of primary operation. As outcome measures, we collected information on FRI, reoperation due to non-union, flap failure, and secondary amputation. We then compared the incidence of complications before and after the implementation of the OTF treatment protocol at TAUH.
    RESULTS: After predefined exclusions, a total of 203 patients with OTF were included. Of these, 141 were treated before and 62 after the implementation of the OTF treatment protocol. The FRI rate in the pre-protocol group was significantly higher compared to the protocol group (20.6% vs 1.6%, p = 0.0015). The incidence of reoperation due to nonunion was also significantly higher in the pre-protocol group (27.7% vs 9.7%, p = 0.0054). According to multivariable analysis, definitive fixation and soft tissue coverage performed in separate operations was an independent risk factor for both FRI and reoperation due to nonunion.
    CONCLUSIONS: After implementation, the BOAST 4 based OTF treatment protocol reduced the rate of FRI and reoperation due to nonunion in patients with OTF treated at TAUH during the study period. We, therefore, recommend the implementation of such a treatment protocol in all major trauma centers treating patients with OTF. Furthermore, we also recommend the immediate referral of patients with complex OTF from hospitals lacking the preconditions to provide BOAST 4 based treatment to specialized centers.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • DOI:
    文章类型: Journal Article
    未经证实:在严重创伤的情况下,下肢抢救需要考虑多种外科专业和治疗算法。我们假设第一次步行的时间到了,没有辅助设备的步行,慢性骨髓炎,延迟截肢不受我们机构GustiloIIIB和IIIC骨折软组织覆盖时间的影响.
    UNASSIGNED:我们评估了2007年至2017年在我们机构接受胫骨开放性骨折治疗的所有患者。包括在初次住院期间需要对下肢进行任何形式的软组织覆盖的患者,并且从出院时起至少进行了30天的随访。对所有感兴趣的变量和结果进行单变量和多变量分析。
    未经批准:纳入575名患者,89需要软组织覆盖。在多变量分析中,覆盖软组织的时间,负压伤口治疗的长度,伤口冲洗次数未发现与慢性骨髓炎的发展有关,减少90天返回任何步行,在没有辅助设备的情况下减少了180天的步行时间,或延迟截肢。
    UNASSIGNED:胫骨开放性骨折软组织覆盖时间不影响首次下床活动时间,没有辅助设备的步行,慢性骨髓炎,或延迟截肢。仍然很难明确证明软组织覆盖时间对下肢结果有意义。
    UNASSIGNED: Lower extremity salvage in the setting of severe trauma requires the consideration of multiple surgical specialties and treatment algorithms. We hypothesized that time to first ambulation, ambulation without an assistive device, chronic osteomyelitis, and delayed amputation were not affected by the time to soft tissue coverage in Gustilo IIIB and IIIC fractures at our institution.
    UNASSIGNED: We evaluated all patients treated for open tibia fractures at our institution from 2007 to 2017. Patients requiring any form of soft tissue coverage to the lower extremity during their initial hospitalization and who had at least 30 days of follow-up from time of hospital discharge were included. Univariable and multivariable analysis was performed for all variables and outcomes of interest.
    UNASSIGNED: Of 575 patients included, 89 required soft tissue coverage. On multivariable analysis, the time to soft tissue coverage, length of negative pressure wound therapy treatment, and number of wound washouts were not found to be associated with development of chronic osteomyelitis, decreased 90-day return to any ambulation, decreased 180-day return to ambulation without assistive device, or delayed amputation.
    UNASSIGNED: Time to soft tissue coverage in open tibia fractures did not affect time to first ambulation, ambulation without an assistive device, chronic osteomyelitis, or delayed amputation in this cohort. It remains difficult to definitively prove that time to soft tissue coverage meaningfully impacts lower extremity outcomes.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Review
    尽管手掌在严重烧伤中大部分都幸免于难,它通常在儿童中受到影响,需要彻底切除收缩性瘢痕组织以允许正常的手发育。由于替代方案仅限于手掌覆盖范围,我们主要使用反向灌注,尺背动脉神经皮皮瓣。我们在此报告我们的长期随访结果。
    我们回顾了10例儿童烧伤后手掌挛缩松解术和皮瓣覆盖手术的长期结果。应用的皮瓣位于尺动脉的背侧分支的远端,并沿手和手腕的尺骨方面收获。襟翼的枢轴点位于背侧,靠近第4和第5掌骨基部。随访患者的中位时间为6年(范围,4-20年)。
    襟翼尺寸在长度60-130mm和宽度20-35mm的范围内。皮瓣尺寸的这种变化是由不同的手尺寸引起的,因为手术中不同的病人年龄。所有皮瓣都存活了,供体部位的愈合是顺利的,边缘皮瓣坏死仅发生一次。观察到满意的运动范围恢复,没有继发性挛缩。此外,我们发现了足够的渐进增长,所有皮瓣的适应性和感觉恢复。随着时间的推移,瓣大多变得无毛和逐渐变平而不脱皮。
    这种皮瓣的重要性在于相当大的组织动员以覆盖手掌缺损而不牺牲任何主要血管轴的潜力。皮瓣的适当进行性生长有助于儿童的功能性手发育。可预测的血管解剖结构,范围广,耐用,薄,和柔软的皮肤使反向神经皮肤尺背动脉皮瓣成为儿童手掌软组织重建的一个有吸引力的选择。
    Although the palm is spared mostly in severe burn injuries, it often is affected in children and requires radical excision of contracting scar tissue to allow normal hand development. Since alternatives are limited for palmar coverage, we primarily use a reverse-perfused, neurocutaneous dorsal ulnar artery flap. We report here our long-term follow-up results.
    We reviewed the long-term results of 10 postburn palmar contracture release and flap coverage procedures in 10 children. The applied flap was based distally on the dorsal branch of the ulnar artery and harvested along the ulnar aspect of the hand and wrist. The pivot point of the flap was located dorsally, close to the 4th and 5th metacarpal base. Patients were followed for a median period of 6 years (range, 4-20 years).
    Flap size ranged from 60-130 mm in length and 20-35 mm in width. This variation in flap dimensions resulted from different hand sizes, because of the various patient ages at surgery. All flaps survived, donor site healing was uneventful, and marginal flap necrosis occurred only once. Satisfactory restoration of range of motion without secondary contractures was observed. Moreover, we detected adequate progressive growth, adaptability and sensory recovery in all flaps. Over time, the flaps mostly become hairless and progressively flattened without debulking.
    The importance of this flap lies in the potential for considerable tissue mobilization to cover palmar defects without sacrificing any major vascular axis. The adequate progressive growth of the flap facilitates functional hand development in children. The predictable vascular anatomy, wide range, and durable, thin, and pliable skin make the reverse neurocutaneous dorsal ulnar artery flap an appealing option for soft tissue reconstruction of the palm in children.
    Therapeutic V.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • 文章类型: Journal Article
    目的:这项系统评价评估了在种植支持修复体的患者中,软组织增强程序对口腔软组织裂开(BSTD)的完全覆盖和平均覆盖的有效性。
    方法:对三个数据库进行了随机调查(RCT),非随机对照临床试验(CCT),队列研究,病例对照研究,和病例系列,每个对照或测试组至少有五名患者。包括涉及软组织增强程序的研究,以涵盖BSTD-在植入物功能期间发生,而不是由于植入物周围炎的结果。使用RoB2或美国国立卫生研究院质量评估评估偏倚风险。只要有可能,我们进行了探索性荟萃分析,以评估不同结局的加权平均效应(WME).主要结果是BSTD的完全覆盖率和平均覆盖率。
    结果:共7篇。只有一项研究是RCT,有很高的偏见风险。荟萃分析表明,在1年后(2项研究,n=36例;WME=70;95%置信区间[CI]=50;90;p=0.23)以及5年后(3项研究,n=54例患者;WME=70;95%;CI=60;80;p=0.44),70%的病例可以完全覆盖BSTD。
    结论:基于有限的证据,可以得出结论,使用软组织增强程序可以大大减少BSTD。需要使用更大样本和更长随访期的比较试验进行进一步研究,以研究长期软组织的稳定性。
    OBJECTIVE: This systematic review evaluated the effectiveness of soft tissue augmentation procedures for complete coverage and mean coverage of buccal soft tissue dehiscence (BSTD) in patients with implant-supported restorations.
    METHODS: Three databases were surveyed for randomized (RCTs), non-randomized controlled clinical trials (CCTs), cohort studies, case-control studies, and case series with a minimum of five patients per control or test group. Studies dealing with soft tissue augmentation procedures to cover BSTD-occurring during implant function and not due to the result of peri-implantitis-were included. Risk of bias was evaluated with RoB 2 or the National Institutes of Health\'s Quality Assessment. Whenever possible, exploratory meta-analyses were performed to evaluate weighted mean effects (WME) for the different outcomes. The primary outcomes were the percentage of complete coverage and mean coverage of BSTD.
    RESULTS: Seven articles were included. Only one study was a RCT, with a high risk of bias. Meta-analyses showed that after 1 year (2 studies, n = 36 patients; WME = 70; 95% confidence interval [CI] = 50; 90; p = .23) as well as after 5 years (3 studies, n = 54 patients; WME = 70; 95%; CI = 60; 80; p = .44), complete coverage of BSTD could be achieved in 70% of the cases.
    CONCLUSIONS: Based on limited evidence, it can be concluded that BSTD can be substantially reduced with the use of soft tissue augmentation procedures. Further research with comparative trials using larger samples and longer follow-up periods is needed to study the stability of soft tissues in the long term.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • 文章类型: Journal Article
    近几十年来,显微外科技术的进步以及重建手术技术的改进扩大了用于残肢手部重建的可用技术的范围。将重建范式从恢复手功能转变为以最小的供体部位发病率提供最佳的功能和美学结果。残缺的手的成功重建不应仅通过手功能的改善程度来衡量,还应通过更具美感的手外观以及改善的心理幸福感来衡量。在这篇文章中,作者提出了他们对残肢手的美学功能重建的概念,重点是重建技术的适应症和选择。他们强调,为了选择最合适的技术,为每个患者提供最佳的功能和美学结果,并提供最小的供体部位发病率,重建手外科医生必须完全掌握所有可用的手术技术,对功能和美学要求的透彻理解,以及对给定手部缺陷的多维重建的准确理解。他们得出结论,在精确指示的情况下,截肢的手或手指的成功再植仍然是最好的重建程序,旨在获得功能更多,外观更正常的手,然而,脚趾到手移植,在失败或不可能的手指再植的情况下,提供比任何其他数字重建技术更好的结果,旨在实现具有良好外观的功能数字。尽管皮肤移植和各种远端带蒂皮瓣和游离皮瓣可能是覆盖一些手部软组织缺损的有效选择,前臂逆流皮瓣,尤其是那些基于前臂的次级动脉,通常是类似手重建的最合适的重建选择。它们可以提供最佳的颜色匹配,纹理,软组织体积,供体-受体组织界面,满足中等大小甚至较大的手部软组织缺损的所有美学和功能重建要求,具有可接受的供体部位发病率。
    Advances in microsurgery together with improvements in reconstructive surgical techniques over recent decades have enlarged the scope of available techniques for mutilated hand reconstruction, shifting the reconstructive paradigm from restoring hand function to providing the best functional and aesthetic results with minimal donor-site morbidity. Successful reconstruction of a mutilated hand should no longer be measured only by the degree of improvement of hand function but also by a more aesthetic hand appearance as well as by improved psychological well-being. In this article, the authors present their concept of aesthetic functional reconstruction of the mutilated hand with a focus on the indications and selection of reconstructive techniques. They emphasize that in order to select the most appropriate technique, providing the best functional and aesthetic outcomes with minimal donor-site morbidity for each individual patient, it is imperative for the reconstructive hand surgeon to possess perfect mastery of all available surgical techniques, thorough understanding of functional and aesthetic requirements and accurate appreciation of multidimensional reconstruction of a given defect of the hand. They have concluded that in precisely indicated cases, successful replantation of an amputated hand or digits remains the best reconstructive procedure designed to obtain a more functional and more normal-appearing hand, whereas, toe-to-hand transplantation, in cases of failed or impossible digit replantation, provides better results than any other digit reconstruction techniques aimed at achieving functioning digits with good appearance. Although skin graft and various distant pedicled flaps and free flaps may be valid options for coverage of some soft tissue defects of the hand, reverse flow forearm flaps, especially those based on the secondary arteries of the forearm, are often the best-suited reconstructive options for like-with-like hand reconstruction. They can provide the best matching of color, texture, soft-tissue volume, donor-recipient tissue interface and fulfill all the aesthetic and functional reconstruction requirements of moderate-sized or even large soft tissue defects of the hand, with acceptable donor site morbidity.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Sci-hub)

  • 文章类型: Journal Article
    腿部皮肤物质的损失是经常发生的,与创伤有关.它需要复杂的管理,需要应用所有当前的重建技术,尤其是显微外科手术。至于治疗,现有的治疗武器库是高度多样化的,从简单的游离皮瓣植皮到局部和局部皮瓣。重建期间,外科医生在手术的目标是美学和功能方面受到几个限制。理想情况下,覆盖腿部前侧的皮肤细度将得到严格遵守。重建旨在产生稳定可靠的皮肤包膜,同时限制供体部位的发病率。通过生产适合腿部皮肤厚度的精细皮瓣并限制供体部位的任何功能和美学后遗症,游离穿支皮瓣的发展符合这两个标准。
    Cutaneous substance loss in the leg is frequent; more often than not, it is trauma-related. It calls for complex management and necessitates the application of all current reconstruction techniques, particularly microsurgery. As regards treatment, the available therapeutic arsenal is highly diversified, ranging from a simple free flap skin graft to local and locoregional flaps. During reconstruction, the surgeon is subjected to several constraints insofar as the objectives of the operation are esthetic as well as functional. Ideally, the fineness of the skin covering the anterior side of the leg will have been scrupulously respected. Reconstruction is aimed at producing a stable and reliable cutaneous envelope while limiting the morbidity of the donor site. The development of free perforator flaps corresponds to these two criteria by producing a fine flap adapted to the cutaneous thickness of the leg and limiting any functional and esthetic sequelae at the donor site.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Sci-hub)

  • 文章类型: Comparative Study
    背景:髂螺钉是一种广泛使用的骶骨骨盆固定技术,由于硬件突出,经常因其伤口愈合受损而受到批评。这项研究的目的是提出一种改良的in骨螺钉(MIS)固定技术,该技术在基本的S1-S2关节旁边的内侧和尾部使用不同的进入点。比较了MIS和传统in骨螺钉中的软组织覆盖率和中线距离。
    方法:将两种不同的髂骨螺钉放入12具新鲜冷冻的成年尸体中(9名男性,3女,平均死亡年龄77.08岁,平均体重指数23.4)。测量中线和螺钉头中心之间的距离。我们还比较了轨迹的角度。伤口闭合后,我们测量了髂螺钉头和皮肤之间的距离。
    结果:从螺钉郁金香头到皮肤的平均距离为2.43厘米(范围,1.2-4.2厘米)与传统的髂骨螺钉和3.16厘米(范围,1.7-4.3厘米)与MIS。到MIS中线的平均距离为3.1厘米(范围,2.4-4.5厘米)与传统的in骨螺钉相比,位于中线的外侧,其中平均值为中线横向4.2厘米(范围,3.7-4.9厘米)。平均角度为10°。
    结论:MIS避免了连接器的使用,并提供了较不突出的骨盆固定。临床上,这可能有助于防止突出的硬件和相关的伤口愈合障碍。
    BACKGROUND: Iliac screws are a widely used sacropelvic fixation technique, which is often criticized for its impaired wound healing owing to hardware prominence. The aim of this study was to present a modified iliac screw (MIS) fixation technique that uses a different entry point more medially and caudally to the posterior superior iliac spine next to the rudimentary S1-S2 joint. Soft tissue coverage and midline distance in an MIS and a traditional iliac screw were compared.
    METHODS: Two different variations of iliac screws were placed into 12 fresh frozen adult cadavers (9 male, 3 female, mean age at death 77.08 years, mean body mass index 23.4). The distance between the midline and the center of the screw head was measured. We also compared the angulation of the trajectories. After wound closure, we measured the distance between the iliac screw head and the skin.
    RESULTS: The mean distance from the screw tulip head to the skin was 2.43 cm (range, 1.2-4.2 cm) with the traditional iliac screw and 3.16 cm (range, 1.7-4.3 cm) with the MIS. The mean distance to the midline with the MIS was 3.1 cm (range, 2.4-4.5 cm) lateral to the midline compared with the traditional iliac screw, of which the mean was 4.2 cm lateral to the midline (range, 3.7-4.9 cm). Mean angulation was 10°.
    CONCLUSIONS: The MIS avoids the use of connectors and provides less prominent pelvic fixation. Clinically, this might help prevent prominent hardware and related wound healing impairment.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Sci-hub)

公众号