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Simultaneous ossicle resection and lateral ligament repair give excellent clinical results with an early return to physical activity in pediatric and adolescent patients with chronic lateral ankle instability and os subfibulare.
同时进行听小骨切除和外侧韧带修复,在慢性外侧踝关节不稳和os亚纤维韧带的儿童和青少年患者中早期恢复体力活动,获得了极好的临床结果。
- 影响因子:3.28
- DOI:10.1007/s00167-019-05718-6
- 作者列表:"Kubo M","Yasui Y","Sasahara J","Miki S","Kawano H","Miyamoto W
- 发表时间:2020-01-01
Abstract
PURPOSE:To elucidate surgical outcomes in pediatric/adolescent patients with chronic lateral ankle instability and os subfibulare. METHODS:A retrospective chart review was conducted of pediatric/adolescent patients with chronic lateral ankle instability and os subfibulare following simultaneous ossicle resection and lateral ligament repair using suture anchors with subsequent immediate full weightbearing and active range of motion exercises for the ankle in our department between 2013 and 2017. Clinical outcomes were evaluated by comparing preoperative and final follow-up American Orthopaedic Foot and Ankle Society Ankle-Hindfoot Scale (AOFAS) and Karlsson-Peterson ankle function scores. Intervals between surgery and return to physical education in school were determined. RESULTS:31 feet of 15 male and 16 female patients were examined. Mean postoperative follow-up duration was 40.7 ± 12.7 (range 24-66) months. Mean AOFAS score increased significantly from 66.3 ± 2.5 (range 62-77) preoperatively to 96.5 ± 4.9 (range 87-100) at final follow-up (p < 0.001). Mean Karlsson-Peterson score increased significantly from 51.7 ± 4.0 (range 47-70) preoperatively to 95.3 ± 6.7 (range 80-100) at final follow-up (p < 0.001). Mean interval between surgery and return to physical education in school was 11.4 ± 1.6 (range 10-18) weeks. CONCLUSION:Simultaneous ossicle resection and lateral ligament repair using suture anchors with subsequent immediate full weightbearing and active ankle range of motion exercises may give excellent clinical outcomes with early return to physical activity for chronic lateral ankle instability with os subfibulare in pediatric/adolescent patients desiring an early return to physical activity. Level of evidence III.
摘要
目的: 阐明儿童/青少年慢性踝关节外侧不稳和os亚fibulare患者的手术疗效。 方法: 对患有慢性外侧踝关节不稳和os的儿童/青少年患者进行了回顾性图表回顾,这些患者在同时进行听小骨切除和外侧韧带修复后使用缝合锚钉,随后立即完全负重和活动范围。2013 年至 2017 年间在我科进行踝关节锻炼。通过比较术前和最终随访美国骨科足踝学会踝-后足量表 (AOFAS) 和Karlsson-Peterson踝关节功能评分来评价临床结局。确定手术和重返学校体育课的间隔时间。 结果: 15 例男性和 16 例女性患者中有 31英尺例接受了检查。平均术后随访时间为 40.7 ± 12.7 (范围 24-66) 个月。平均AOFAS评分从术前的 66.3 ± 2.5 (范围 62-77) 显著增加到 96.5 ± 4.9 (范围 87-100) 最终随访时 (p <0.001)。平均Karlsson-Peterson评分从术前的 51.7 ± 4.0 (范围 47-70) 显著增加到 95.3 ± 6.7 (范围 80-100) 最终随访时 (p <0.001)。手术和重返学校体育的平均间隔时间为 11.4 ± 1.6 (范围 10-18) 周。 结论: 同时进行听小骨切除和外侧韧带修复 (使用缝合锚钉),随后立即进行完全负重和积极的踝关节活动度练习,对于伴有os的慢性外侧踝关节不稳定,可以早期恢复体力活动,从而获得极好的临床效果。渴望早期恢复体力活动的儿童/青少年患者的皮下注射。证据级别III。
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METHODS:OBJECTIVE:Patients with immune-mediated inflammatory diseases such as rheumatoid arthritis or systemic lupus erythematosus are at increased risk of cardiovascular disease. However, the cardiovascular risk of patients with primary Sjögren's syndrome (SS) remains poorly studied. We aimed to investigate the association between primary SS and cardiovascular morbidity and mortality. METHODS:We performed a systematic review of articles in Medline and the Cochrane Library and recent abstracts from US and European meetings, searching for reports of randomized controlled studies of cardiovascular morbidity and cardiovascular mortality in primary SS. The relative risk (RR) values for cardiovascular morbidity and mortality associated with primary SS were collected and pooled in a meta-analysis with a random-effects model by using Review Manager (Cochrane collaboration). RESULTS:The literature search revealed 484 articles and abstracts of interest; 14 studies (67,124 patients with primary SS) were included in the meta-analysis. With primary SS versus control populations, the risk was significantly increased for coronary morbidity (RR 1.34 [95% confidence interval (95% CI) 1.06-1.38]; P = 0.01), cerebrovascular morbidity (RR 1.46 [95% CI 1.43-1.49]; P < 0.00001), heart failure rate (odds ratio 2.54 [95% CI 1.30-4.97]; P < 0.007), and thromboembolic morbidity (RR 1.78 [95% CI 1.41-2.25]; P < 0.00001), with no statistically significant increased risk of cardiovascular mortality (RR 1.48 [95% CI 0.77-2.85]; P = 0.24). CONCLUSION:This meta-analysis demonstrates that primary SS is associated with increased cardiovascular morbidity, which suggests that these patients should be screened for cardiovascular comorbidities and considered for preventive interventions, in a multidisciplinary approach with cardiologists.
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各类骨关节疾病,包括退行性关节炎、滑囊炎、滑膜炎、颈椎病、腰椎病、肩周炎、骨质增生、风湿性关节炎、类风湿性关节炎、股骨头坏死等。