背景:保持功能独立性的老年患者现在可以成为原发性腕关节置换术的候选人,以治疗急性不可修复的桡骨远端骨折(DRF)。然而,需要进一步调查和长期随访以验证这些初步发现.
目的:回顾关于桡骨远端半关节置换术的结果的文献,以评估其作为治疗选择的可行性。
方法:使用电子数据库对文献进行了全面回顾,包括PubMed,Medline,还有Scopus.使用的搜索词是“桡骨远端骨折”,“半髋关节置换术”,“腕关节置换术”,和相关术语。搜索仅限于1980年至2023年6月以英文发表的文章。纳入标准包括使用半髋关节置换术治疗的DRF病例或病例系列,提供临床或影像学结果,并在同行评审的期刊上发表。
结果:最初共确定了PubMed的2508篇文章和Scopus的883篇文章。在筛选和删除重复项之后,13条符合纳入标准。这些文章,主要是临床回顾性研究,提供了对半髋关节置换术结果的见解,包括功能改善和并发症。半髋关节置换术是复杂DRF的治疗选择,特别是那些严重粉碎的病例,关节内受累,或严重的骨质疏松症。功能结果显示疼痛缓解的改善,手腕活动能力,和握力,在研究中具有变异性。并发症包括植入物松动,感染,神经损伤,和刚度,不同的发病率受手术技术和植入物选择的影响。长期结果记录不充分,保证进一步的研究。
结论:半髋关节置换术是治疗老年人无法修复的DRF的一种有希望的治疗方法。长期结果和并发症需要进一步研究。
BACKGROUND: Elderly patients maintaining functional independence can now be candidates for primary wrist hemiarthroplasty to manage acute irreparable distal radius fractures (DRFs). However, further investigation with long-term follow-up is required to validate these initial findings.
OBJECTIVE: To review the literature on the outcomes of distal radius
hemiarthroplasty with available implants to assess its viability as a treatment option.
METHODS: A comprehensive review of the literature was conducted using electronic databases, including PubMed, Medline, and Scopus. The search terms employed were \"distal radius fracture\" , \"
hemiarthroplasty\" , \"wrist arthroplasty\" , and related terminology. The search was restricted to articles published in English from 1980 until June 2023. Inclusion criteria encompassed cases or case series of DRF treated with hemiarthroplasty, providing clinical or radiographic outcomes, and published in peer-reviewed journals.
RESULTS: A total of 2508 articles from PubMed and 883 from Scopus were identified initially. Following screening and removal of duplicates, 13 articles met the inclusion criteria. These articles, predominantly clinical retrospective studies, provided insights into
hemiarthroplasty outcomes, including functional improvements and complications.
Hemiarthroplasty was a treatment option for complex DRF, particularly those cases with severe comminution, intraarticular involvement, or severe osteoporosis. Functional outcomes demonstrated improvements in pain relief, wrist mobility, and grip strength, with variability across studies. Complications included implant loosening, infection, nerve injury, and stiffness, with varying incidence rates influenced by surgical techniques and implant choice. Long-term outcomes were inadequately documented, warranting further research.
CONCLUSIONS: Hemiarthroplasty is a promising treatment for irreparable DRF in the elderly. Long-term outcomes and complications require further study.