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一项关于舟状骨急性无移位骨折的前瞻性多中心队列研究:手术治疗与非手术治疗对比 [NCT00205985]

A prospective multi-center cohort study of acute non-displaced fractures of the scaphoid: operative versus non-operative treatment [NCT00205985].

作者信息

Pfeiffer Boris M, Nübling Matthias, Siebert Hartmut R, Schädel-Höpfner Michael

机构信息

AO Clinical Investigation and Documentation, Clavadelerstrasse 8, CH-7270 Davos Platz, Switzerland.

出版信息

BMC Musculoskelet Disord. 2006 May 11;7:41. doi: 10.1186/1471-2474-7-41.

Abstract

BACKGROUND

Acute scaphoid fractures are common in active adults and do lead to reasonable time lost to work. One important goal of treatment is early return to work or sport. On this background, the adequate treatment of non-displaced acute scaphoid fractures is still under discussion. The aim of this study is to compare time to return to previous activity level comparing surgical versus non-surgical treatment of non-displaced acute scaphoid fractures.

METHODS/DESIGN: The study is designed as a non-randomized multiple center cohort study including 12 sites in Germany and Austria. The inclusion period is planned to be 12 months with a follow up of 6 months. Allocation to operative or non-operative treatment is chosen by the patient together with his treating surgeon. The primary outcome is time to return to previous activity level adapted for loading of the wrist in daily life as measured by a newly developed questionnaire (PLDL-wrist). Factors identified a priori to be associated with the outcome, e.g., poverty status, age, education, smoking status, gender, and occupation, are measured to ensure adequate control for their potential confounding effects.

DISCUSSION

The rationale and the design of a multiple center cohort study are presented. As it is not considered feasible to randomize patients in this study, potential confounding effects need to be controlled adequately.

摘要

背景

急性舟骨骨折在活跃的成年人中很常见,确实会导致相当长的工作时间损失。治疗的一个重要目标是早日恢复工作或运动。在此背景下,无移位急性舟骨骨折的适当治疗仍在讨论中。本研究的目的是比较无移位急性舟骨骨折手术治疗与非手术治疗恢复到先前活动水平的时间。

方法/设计:本研究设计为非随机多中心队列研究,包括德国和奥地利的12个地点。纳入期计划为12个月,随访6个月。手术或非手术治疗的分配由患者与其主治外科医生共同决定。主要结局是通过新开发的问卷(PLDL-手腕)测量恢复到适合日常生活中手腕负荷的先前活动水平的时间。测量事先确定与结局相关的因素,如贫困状况、年龄、教育程度、吸烟状况、性别和职业,以确保充分控制其潜在的混杂效应。

讨论

介绍了多中心队列研究的基本原理和设计。由于在本研究中对患者进行随机分组不可行,因此需要充分控制潜在的混杂效应。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5c60/1475583/5588f0d5a2db/1471-2474-7-41-1.jpg

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