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伴有移位骶骨骨折的骨盆创伤:一年时的功能结局

Pelvic trauma with displaced sacral fractures: functional outcome at one year.

作者信息

Tötterman Anna, Glott Thomas, Søberg Helene Lundgaard, Madsen Jan Erik, Røise Olav

机构信息

Ullevål University Hospital, Orthopaedic Department, Oslo, Norway.

出版信息

Spine (Phila Pa 1976). 2007 Jun 1;32(13):1437-43. doi: 10.1097/BRS.0b013e318060a68f.

Abstract

STUDY DESIGN

A prospective single-cohort study of 31 patients surgically treated for pelvic injuries with displaced sacral fractures.

OBJECTIVE

To describe the medium term functional outcome in unstable sacral fractures.

SUMMARY OF BACKGROUND DATA

Displaced sacral fractures pose a special challenge in orthopedic surgery due to the high rate of associated injuries. Little information is available on the medium-term functional outcome of patients with injuries which include unstable sacral fractures.

METHODS

We examined 31 patients with displaced sacral fractures having 10 mm or more displacement, 1 year (mean, 1.4 years; range, 1.0-2.5 years) after injury. Data from a previous study were supplemented with functional outcome measures (work status, independence in ADL, and SF-36). An association between outcome and tested variables was sought.

RESULTS

Fifteen months after injury, 65% of the patients had regained their independence in functions pertaining to daily activities; 33% had returned to work. All dimensions of perceived health were affected. Polytrauma and impairments relative to voiding and sexual function had a detrimental effect on outcome. Fracture characteristics were not predictive of poor outcome.

CONCLUSIONS

Although the majority of patients achieved independent living, medium-term follow-up indicated significant residual disability. The complex nature of these fractures and the associated injuries should be considered in the rehabilitation of these patients.

摘要

研究设计

一项对31例因骨盆损伤伴骶骨骨折移位而接受手术治疗患者的前瞻性单队列研究。

目的

描述不稳定骶骨骨折的中期功能结局。

背景资料总结

由于合并伤发生率高,骶骨骨折移位给骨科手术带来特殊挑战。关于包括不稳定骶骨骨折在内的损伤患者中期功能结局的信息较少。

方法

我们检查了31例骶骨骨折移位10毫米或以上的患者,受伤后1年(平均1.4年;范围1.0 - 2.5年)。以前研究的数据补充了功能结局指标(工作状态、日常生活活动独立性和SF - 36)。寻找结局与测试变量之间的关联。

结果

受伤15个月后,65%的患者在与日常活动相关的功能方面恢复了独立;33%的患者已重返工作岗位。所有感知健康维度均受到影响。多发伤以及排尿和性功能方面的损伤对结局有不利影响。骨折特征不能预测不良结局。

结论

尽管大多数患者实现了独立生活,但中期随访表明仍有明显的残余残疾。在这些患者的康复过程中应考虑这些骨折及其相关损伤的复杂性。

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