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AAOS指南(2022)|关于桡骨远端骨折的7条临床操作建议

2022-04-17 网络 网络

桡骨远端骨折(distal radius fracture, DRF)是临床最常见的骨折之一,发病率呈双峰分布,占青少年骨折的25%及老龄患者骨折的18%。

查看指南原文:2020 AAOS/ASSH临床实践指南:桡骨远端骨折的管理(概要)

桡骨远端骨折(distal radius fracture, DRF)是临床最常见的骨折之一发病率呈双峰分布,占青少年骨折的25%及老龄患者骨折的18%。

2022年,美国骨科医师协会(The American Academy of Orthopaedic Surgeons,AAOS与手外科医师协会(The American Society for Surgery of the Hand,ASSH联合推出了桡骨远端骨折的临床操作指南,包含7条建议,供临床参考。

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所有的推荐根据证据等级划分:

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七条具体建议

一. 关节镜辅助(arthoscopic assistance)

在治疗桡骨远端骨折时,关节镜辅助与非关节镜辅助在治疗结果上无明显差异。(证据指数:中等)

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二. 居家锻炼计划(home exercise program)

居家锻炼与治疗师监督下锻炼,结果上无差异。(证据指数:有限)

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三. 内固定指征(≤65岁)

对于桡骨短缩大于3mm,背侧成角大于10°,关节面移位或间隙大于2mm患者,手术内固定治疗能够获得更好的影像学及治疗结果。(证据指数:中等)

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四. 内固定指征(>65岁)

手术治疗及非手术治疗在长远结果来看,无差异。(证据指数:强)

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五. 影像学随访(serial radiography)

有限的证据表明,影像学复查的频率,对于治疗结果无差异。(证据指数:有限)

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六. 内固定技术(fixation technique)

强有力的证据表明,对于关节内骨折或不稳定的桡骨远端骨折,不同的固定方式在影像学及患者报告的结果来看,无显著差异。尽管掌侧锁定板能进行早期功能康复。(证据指数:强)

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七. 阿片类止痛药使用(opioid use)

无证据支持,但是专家组建议对于桡骨远端骨折治疗的患者,应考虑阿片类药物和多模式镇痛管理。(证据指数:专家共识)        

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    2022-07-24 yinhl1978
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    2022-05-26 ms3000000855941857

    学习了

    0

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    2022-05-09 ms5000000008511150

    学习了

    0

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    2022-04-22 ms5000000518166734

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