Hoogendoorn J M, van der Werken C
University Medical Centre Utrecht, Department of Surgery, Postbus 85500, 3508 GA Utrecht, The Netherlands.
Injury. 2001 May;32(4):329-34. doi: 10.1016/s0020-1383(00)00250-3.
The purpose of this study was to assess the long-term functional outcome and the quality of life of patients who were treated for a (Gustilo) Grade III open tibial fracture. We included 43 patients with successful limb salvage (group A) and 21 amputees (group B). The groups were similar with regard to age, sex, and Injury Severity Score (ISS). The functional outcome was scored using the "Guides to the Evaluation of Permanent Impairment". To compare quality of life we used the Nottingham Health Profile (NHP), the SF-36, and a questionnaire especially designed for this study. The mean lower extremity impairment (AMA) of patients in group A was 17.6%, compared to 73.5% for patients in group B. The results with both NHP and SF-36 show that patients in both groups have more problems in most categories than a healthy reference group. With the NHP, the difference in score was largest for the categories of pain, mobility, energy and sleep. The SF-36 scores correlated well with the NHP scores. No significant difference was found between the two groups. This type of injury has an enormous impact on every aspect of life--irrespective of the chosen treatment. A significant difference in lower extremity impairment is found between patients with a successful reconstruction and those who are amputees. However, the quality of life was shown to be the same.
本研究的目的是评估接受（ Gustilo）Ⅲ级开放性胫骨骨折治疗的患者的长期功能结局和生活质量。我们纳入了43例保肢成功的患者（A组）和21例截肢患者（B组）。两组在年龄、性别和损伤严重程度评分（ISS）方面相似。使用“永久性损伤评估指南”对功能结局进行评分。为比较生活质量，我们使用了诺丁汉健康量表（NHP）、SF-36以及专门为本研究设计的一份问卷。A组患者下肢平均损伤（AMA）为17.6%，而B组患者为73.5%。NHP和SF-36的结果均显示，两组患者在大多数类别中比健康对照组存在更多问题。使用NHP时，疼痛、活动能力、精力和睡眠类别得分差异最大。SF-36得分与NHP得分相关性良好。两组之间未发现显著差异。无论选择何种治疗方式，这类损伤都会对生活的各个方面产生巨大影响。成功重建的患者与截肢患者在下肢损伤方面存在显著差异。然而，生活质量显示相同。
