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桡骨远端骨折后恢复的种族差异。

Ethnic disparities in recovery following distal radial fracture.

机构信息

NYU Hospital for Joint Diseases, New York, NY 10003, USA.

出版信息

J Bone Joint Surg Am. 2010 May;92(5):1082-7. doi: 10.2106/JBJS.H.01329.

Abstract

BACKGROUND

Ethnic disparities have been demonstrated in the treatment of chronic diseases, such as diabetes and heart disease. It is unclear if similar ethnic disparities appear with respect to recovery following fracture care.

METHODS

We retrospectively reviewed 496 individuals (253 whites, 100 blacks, and 143 Latinos) with a fracture of the distal part of the radius. Assessment of physical function and pain was conducted at three, six, and twelve months following treatment. The Disabilities of the Arm, Shoulder and Hand (DASH) score was used to assess physical function, and a visual analog scale was used to assess pain. Multiple linear regression was used to model physical function and pain across ethnicity while controlling for age, sex, mechanism of injury, level of education, type of fracture, type of treatment (operative or nonoperative), and Workers' Compensation status.

RESULTS

Both blacks and Latinos exhibited poorer physical function and greater pain than whites did at most follow-up points. Latinos reported more pain at each follow-up point in comparison with blacks and whites (p < 0.001 at three, six, and twelve months). These significant differences remained after controlling for Workers' Compensation status, which was also strongly associated with both pain and function.

CONCLUSIONS

These findings suggest that recovery is different between ethnic groups following a fracture of the distal part of the radius. These ethnic disparities may result from multifactorial sociodemographic factors that are present both before and after fracture treatment.

摘要

背景

在糖尿病和心脏病等慢性病的治疗中,已经出现了种族差异。目前尚不清楚在骨折治疗后的康复方面是否也存在类似的种族差异。

方法

我们回顾性分析了 496 名(253 名白人、100 名黑人、143 名拉丁裔)桡骨远端骨折患者。在治疗后 3、6 和 12 个月,对患者的身体功能和疼痛情况进行评估。使用手臂、肩部和手部残疾(DASH)评分评估身体功能,使用视觉模拟评分法评估疼痛。采用多元线性回归模型,在控制年龄、性别、损伤机制、受教育程度、骨折类型、治疗方式(手术或非手术)和工伤保险状态的情况下,对不同种族之间的身体功能和疼痛进行建模。

结果

在大多数随访点,黑人和拉丁裔患者的身体功能均比白人差,疼痛也更严重。与黑人和白人相比,拉丁裔患者在每个随访点的疼痛评分都更高(在 3、6 和 12 个月时,差异均 P < 0.001)。在控制工伤保险状态后,这些差异仍然存在,而工伤保险状态与疼痛和功能均密切相关。

结论

这些发现表明,桡骨远端骨折患者在不同种族之间的康复情况存在差异。这些种族差异可能是由多种社会人口因素造成的,这些因素在骨折治疗前后都存在。

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