Kasapinova K, Kamiloski V
University Surgical Clinic St. Naum Ohridski, Skopje, R. Macedonia.
Prilozi. 2009 Dec;30(2):185-96.
Evidence of the disability and quality of life after a distal radius fracture reported by the patients themselves is lacking, since previous studies focussed on radiological assessment and objective clinical parameters.
To describe the pain and disability and how they change during 6 months of recovery in patients with distal radius fracture.
This is a prospective randomized study of 42 patients with a distal radius fracture. They were assessed three times: baseline visit (7-10 day), three and six months after injury. At each visit patients completed the PRWE (Patient -rated wrist evaluation) questionnaire with 15 items: 5 - Pain; 6 - Specific activities and 4 - Usual activities subscale.
At baseline patients experience moderate pain (minimal at rest, mild during repeated movement, severe when lifting), there is very severe disability in performing specific and usual activities. After three months the pain diminishes to mild (none at rest, mild when lifting), as well the disability that is mild (professional activity is affected most). Six months after injury there is only minimal pain and functional difficulties. The domains of specific activities remained more impaired at each phase, compared to usual activities (personal care and household work).
The results of this study describe the normal course of recovery after a distal radius fracture. Three months after the injury significant improvement is expected, and after six months there should be only minimal disability. Atypical recovery may suggest the appearance of a complication or a need to change the treatment protocol.
由于先前的研究集中在放射学评估和客观临床参数上,缺乏患者自身报告的桡骨远端骨折后残疾情况和生活质量的证据。
描述桡骨远端骨折患者在6个月康复期间的疼痛和残疾情况以及它们如何变化。
这是一项对42例桡骨远端骨折患者进行的前瞻性随机研究。对他们进行了三次评估:基线访视(伤后7 - 10天)、伤后三个月和六个月。每次访视时,患者完成包含15个项目的PRWE(患者自评腕关节评估)问卷:5项关于疼痛;6项关于特定活动;4项关于日常活动子量表。
在基线时,患者经历中度疼痛(休息时轻微,重复活动时轻度,提举时严重),在进行特定和日常活动时存在非常严重的残疾。三个月后,疼痛减轻至轻度(休息时无疼痛,提举时轻度),残疾程度也为轻度(职业活动受影响最大)。伤后六个月,只有轻微疼痛和功能困难。与日常活动(个人护理和家务劳动)相比,特定活动领域在每个阶段的受损程度仍然更高。
本研究结果描述了桡骨远端骨折后的正常康复过程。受伤三个月后有望显著改善,六个月后应只有轻微残疾。非典型康复可能提示出现并发症或需要改变治疗方案。