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老年患者上肢损伤最终会导致无助吗?一项针对65岁以上个体桡骨远端和肱骨近端骨折结局的前瞻性研究

[Do injuries of the upper extremity in geriatric patients end up in helplessness? A prospective study for the outcome of distal radius and proximal humerus fractures in individuals over 65].

作者信息

Einsiedel T, Becker C, Stengel D, Schmelz A, Kramer M, Däxle M, Lechner F, Kinzl L, Gebhard F

机构信息

Abteilung für Unfall-, Hand-, Plastische und Wiederherstellungschirurgie, Universitätsklinikum Ulm, Steinhövelstrasse 9, 89075, Ulm, Germany.

出版信息

Z Gerontol Geriatr. 2006 Dec;39(6):451-61. doi: 10.1007/s00391-006-0378-2.

Abstract

In a prospective study 104 patients >or=65 years with distal radius fractures (DRF; n=52) and proximal forearm fractures (PHF; n=52) were followed up for a period of 4 months after injury. As an inception- cohort study, influence on treatment pattern was not part of the examination. A total of 53% of the DRF and 74% of the PHF patients underwent surgery. There were no significant changes in the ability of daily living management (IADL) with either fracture form. Functional outcome was better in PHF than DRF patients. PHF patients showed a high incidence in "fear of falling" throughout the whole study, whereas fear of falling rose significantly in DRF patients. 4% of DRF and 9.6% of PHF patients died during the observation period, while 6% of DRF and even 17% of PHF patients had to give up their own housekeeping. One third of both patient groups did not receive physiotherapy. In only 12% of DRF and 6% of PHF patients was osteoporosis treated. In both groups of patients there was a significant worsening in the ability of walking after injury, leading to two or more new falls in 24% of DRF and 28% of PHF patients.

摘要

在一项前瞻性研究中,对104例年龄≥65岁的桡骨远端骨折(DRF;n = 52)和前臂近端骨折(PHF;n = 52)患者在受伤后进行了为期4个月的随访。作为一项队列起始研究,对治疗模式的影响并非检查的一部分。共有53%的DRF患者和74%的PHF患者接受了手术。两种骨折类型患者的日常生活管理能力(IADL)均无显著变化。PHF患者的功能结局优于DRF患者。在整个研究过程中,PHF患者“害怕跌倒”的发生率较高,而DRF患者害怕跌倒的情况显著增加。在观察期内,4%的DRF患者和9.6%的PHF患者死亡,而6%的DRF患者甚至17%的PHF患者不得不放弃自理家务。两组患者中均有三分之一未接受物理治疗。仅12%的DRF患者和6%的PHF患者接受了骨质疏松症治疗。两组患者受伤后的行走能力均显著恶化,导致24%的DRF患者和28%的PHF患者出现两次或更多次新的跌倒。

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