Department of Rehabilitation Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China.
J Rehabil Med. 2011 May;43(6):515-20. doi: 10.2340/16501977-0813.
The aim of this study was to analyse the various factors affecting functional recovery of earthquake survivors with tibial shaft fractures in Sichuan, China, and to provide a clinical reference for the future management of people injured in earthquakes.
A total of 174 earthquake survivors with tibial shaft fractures were investigated using a face-to-face survey 15 months after the earthquake. Functional recovery after fracture was evaluated by Johner-Wruhs' criteria. Thirteen of the parameters that may influence functional recovery after fracture were included. Univariate and multiple stepwise logistic regression analyses were employed.
Functional recovery was positively associated with rehabilitation intervention (odds ratio 5.3 (95% confidence interval 2.38-11.67)), but negatively correlated with the immobilization duration (odds ratio (per 10 days increase) 0.87 (95% confidence interval 0.798-0.947)), age (odds ratio (per 10 years increase) 0.54 (95% confidence interval 0.418-0.707)) and depressive symptomatology (odds ratio 0.21 (95% confidence interval 0.063-0.716)).
Functional recovery of post-earthquake survivors with tibial shaft fractures is related mainly to availability of rehabilitation intervention, duration of immobilization, post-earthquake depressive symptomatology, and age. These results may support the future development of strategies for optimizing functional recovery of survivors with lower limb fracture after massive natural disasters.
本研究旨在分析影响中国四川地震后胫骨骨干骨折幸存者功能恢复的各种因素，为未来地震伤员的管理提供临床参考。
采用面对面调查的方式，对 174 名地震后胫骨骨干骨折幸存者进行调查，在地震后 15 个月评估骨折后功能恢复情况，采用 Johner-Wruhs 标准进行评估。共纳入 13 个可能影响骨折后功能恢复的参数。采用单因素和多步逻辑回归分析。
功能恢复与康复干预呈正相关（优势比 5.3（95%置信区间 2.38-11.67）），与固定时间呈负相关（每增加 10 天的优势比（OR）0.87（95%置信区间 0.798-0.947）），与年龄（OR 每增加 10 岁）0.54（95%置信区间 0.418-0.707））和抑郁症状（OR 0.21（95%置信区间 0.063-0.716））呈负相关。
地震后胫骨骨干骨折幸存者的功能恢复主要与康复干预的可用性、固定时间、地震后抑郁症状和年龄有关。这些结果可能支持未来为优化大规模自然灾害后下肢骨折幸存者功能恢复而制定策略。
