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首页> 外文期刊>Ultrasound in Medicine and Biology >Extracorporeal shockwaves versus surgery in the treatment of pseudoarthrosis of the carpal scaphoid.
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Extracorporeal shockwaves versus surgery in the treatment of pseudoarthrosis of the carpal scaphoid.

机译：体外冲击波与手术治疗腕舟骨假性关节炎。

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摘要

The peculiar anatomical characteristics and precarious vascularization of the carpal scaphoid are responsible for a difficult healing of fractures and a fairly frequent subsequent evolution to pseudoarthrosis. Recently, extracorporeal shockwaves therapy (ESWT) has yielded encouraging results in the treatment of pseudoarthrosis of various bone segments. We report a retrospective study comparing the results of application of three sessions of shockwaves therapy (SW) with energy flux density (EFD) impulses of 0.09 (SD = 0.02) mJ/mm(2) ESWT emitted by an electromagnetic generator in 58 patients (group I) affected by pseudoarthrosis of the carpal scaphoid, with the results of surgical treatment consisting of stabilization and bone graft according to the Matti-Russe technique, performed in 60 subjects (controls, group II). There were no statistically significant differences in the mean duration of the pseudoarthrosis (p = 0.46), sex distribution (p = 0.41) and mean age at recruitment (p = 0.95) between the two patient groups. Posttreatment clinical-functional assessment, based on the Mayo Wrist Score, showed a significantly improved score, rising from 28-74.6 in group I already after 2 mo (p < 0.001), with 86.3% of the results judged as satisfactory or excellent; in group II the mean score rose from 27.5-74.2 after 2 mo, with 83.4% of the results judged as satisfactory or excellent (p < 0.001). At the same two-months follow-up (FU), radiographic consolidation was shown in 75.9% of patients in group I and 76.7% in group II. These improvements persisted at the subsequent controls at six and 12 mo in both groups. The Mayo Wrist Score and X-rays did not show statistically significant differences at the various FU visits in the two groups (p > 0.05). On the basis of our data, we can conclude that the results of ESWT are comparable with those of surgical stabilization and bone graft in the treatment of scaphoid pseudoarthrosis. In view of their minimal invasiveness, shockwaves should therefore be considered the treatment of choice of this disorder.
机译：腕舟骨的特殊解剖学特征和不稳定的血管形成是造成骨折难以愈合以及随后相当频繁地发展为假性关节炎的原因。最近，体外冲击波疗法（ESWT）在治疗各种骨节段的假性关节炎方面取得了令人鼓舞的结果。我们报告了一项回顾性研究，对58例患者中电磁发生器发出的0.09（SD = 0.02）mJ / mm（2）ESWT的三波冲击波疗法（SW）与能量通量密度（EFD）脉冲的应用结果进行了比较（第一组）受腕舟骨假性关节炎的影响，根据Matti-Russe技术进行的包括稳定化和植骨在内的外科治疗结果在60位受试者中进行（对照组，第二组）。两组患者之间的假性关节炎的平均持续时间（p = 0.46），性别分布（p = 0.41）和招募时的平均年龄（p = 0.95）没有统计学差异。基于Mayo Wrist评分的治疗后临床功能评估显示评分显着提高，从第一组的2 mo后已经从28-74.6上升（p <0.001），其中86.3％的结果被判定为满意或优秀。在第二组中，平均得分从2个月后的27.5-74.2提高到83.4％的结果被判定为满意或优秀（p <0.001）。在相同的两个月随访（FU）中，I组患者的X线影像合并显示为75.9％，II组患者为76.7％。这些改善在两组分别在六个月和十二个月的后续对照组中持续存在。两组的每次FU访视时，Mayo手腕评分和X射线均未显示出统计学上的显着差异（p> 0.05）。根据我们的数据，可以得出结论，在舟状假性关节炎的治疗中，ESWT的结果与手术稳定和植骨的结果相当。考虑到其最小的侵入性，因此应考虑使用冲击波治疗该疾病。

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