Aviv Barak, Bar-On Elhanan, Weigl Daniel, Becker Tal, Katz Kalman
Department of Orthopedics, Rabin Medical Center, Beilinson Hospital, Petah Tiqwa, Israel.
J Child Orthop. 2008 Jun;2(3):221-4. doi: 10.1007/s11832-008-0093-1. Epub 2008 Mar 6.
The purpose of this prospective study was to assess the impact of cast immobilization on the activities of daily living in children with fractured upper limbs.
Using the Activities Scale for Kids (ASK), 52 consecutive children (17 girls, 35 boys), aged 5-15 years (mean, 9 years), with upper limb fractures treated by means of above- or below-elbow casts were assessed. The files were reviewed for background and fracture-related data.
Mean score of the above-elbow group was 65.4 +/- 15.5 points on the ASK capability domain (ASK-c) (with cast) and 98.7 +/- 3 points on the ASK-performance domain (without cast). Corresponding scores for the below-cast group were 89.8 +/- 13 and 99.5 +/- 2. Factors that positively affected overall function were older age, male sex, shorter duration of pain, and less displacement. On multivariate analysis, only age proved to be a potential predictive factor. Cast position and hand dominance had no effect. The specific activities affected were personal hygiene, dressing, making a snack, and reaching high objects.
To ease their children's adjustment to forearm cast immobilization after fractures, parents should be educated in the areas of daily living that may be affected. This is particularly true for younger children with more displaced fractures that cause more pain.
这项前瞻性研究的目的是评估石膏固定对上肢骨折儿童日常生活活动的影响。
使用儿童活动量表（ASK），对52例连续的5至15岁（平均9岁）上肢骨折患儿进行评估，这些患儿接受了肘上或肘下石膏治疗。查阅病历以获取背景和骨折相关数据。
肘上组在ASK能力域（ASK-c）（佩戴石膏）的平均得分为65.4±15.5分，在ASK表现域（未佩戴石膏）的平均得分为98.7±3分。石膏下组的相应分数分别为89.8±13分和99.5±2分。对总体功能有积极影响的因素包括年龄较大、男性、疼痛持续时间较短和移位较少。多因素分析显示，只有年龄被证明是一个潜在的预测因素。石膏位置和利手没有影响。受影响的具体活动包括个人卫生、穿衣、制作零食和够取高处物品。
为帮助孩子在骨折后更好地适应前臂石膏固定，应就可能受影响的日常生活领域对家长进行教育。对于骨折移位较多、疼痛更严重的年幼患儿尤其如此。
