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桡骨远端切开复位内固定患者急性腕管松解术后的患者报告结局

Patient-reported outcomes after acute carpal tunnel release in patients with distal radius open reduction internal fixation.

作者信息

Chauhan Aakash, Bowlin Timothy C, Mih Alexander D, Merrell Gregory A

机构信息

The Indiana Hand to Shoulder Center, 8501 Harcourt Road, Indianapolis, IN 46260 USA ; Department of Orthopaedics, Allegheny General Hospital, 1307 Federal St, Suite 200, Pittsburgh, PA 15212 USA.

出版信息

Hand (N Y). 2012 Jun;7(2):147-50. doi: 10.1007/s11552-012-9400-x.

Abstract

BACKGROUND

Acute carpal tunnel syndrome (CTS) is a complication that can develop after distal radius fractures. Our hypothesis tested whether patient-reported outcomes after acute carpal tunnel release (CTR) performed in combination with distal radius fracture open reduction internal fixation (ORIF) are worse than patient-reported outcomes with only elective CTR as measured by the symptom severity and functional status scales of the Boston carpal tunnel questionnaire (BCTQ).

METHODS

A retrospective assessment identified 26 patients treated with acute CTR at the same time as distal radius ORIF, no history of pre-existing CTS or CTR, no other injuries, and >12 months follow-up. Sixteen of these patients (Group A) could be contacted and answered the BCTQ. Group A was age- and sex-matched to control patients (Group B) treated with only elective CTR. A case-control study was performed comparing outcomes of both groups.

RESULTS

The average age of patients was 51 ± 15 years, with an average follow-up of Group A at 49 ± 21 months versus Group B at 55 ± 20 months. The mean symptom severity scale score for Group A was 1.4 ± 0.4 and for Group B was 1.4 ± 0.4. The mean functional status scale score for Group A was 1.4 ± 0.5 and for Group B was 1.3 ± 0.4. The mean total BCTQ score for Group A was 26.5 ± 7.5 and for Group B was 24.9 ± 7.5. There were no statistical or clinically significant differences between Group A and Group B for symptom severity, functional status, and total BCTQ scores.

CONCLUSIONS

Patients with acute CTR performed at the same time with distal radius ORIF do as well in the long-term as those patients with only elective CTR as measured by the BCTQ. Patients should expect similar recovery of subjective nerve function from acute median nerve dysfunction when CTR is performed with distal radius ORIF as patients with only elective CTR.

摘要

背景

急性腕管综合征(CTS)是桡骨远端骨折后可能出现的一种并发症。我们的假设是,通过波士顿腕管问卷(BCTQ)的症状严重程度和功能状态量表来衡量,与仅行择期腕管松解术(CTR)相比,在桡骨远端骨折切开复位内固定术(ORIF)的同时行急性腕管松解术(CTR)后的患者报告结局是否更差。

方法

一项回顾性评估确定了26例在桡骨远端ORIF的同时接受急性CTR治疗的患者,这些患者既往无CTS或CTR病史,无其他损伤,且随访时间>12个月。其中16例患者(A组)能够被联系并回答BCTQ。A组在年龄和性别上与仅接受择期CTR治疗的对照患者(B组)相匹配。进行了一项病例对照研究,比较两组的结局。

结果

患者的平均年龄为51±15岁,A组的平均随访时间为49±2l个月,B组为55±20个月。A组的平均症状严重程度量表评分为1.4±0.4,B组为1.4±0.4。A组的平均功能状态量表评分为1.4±0.5,B组为1.3±0.4。A组的平均BCTQ总评分为26.5±7.5,B组为24.9±7.5。A组和B组在症状严重程度、功能状态和BCTQ总评分方面无统计学或临床显著差异。

结论

通过BCTQ测量,在桡骨远端ORIF的同时进行急性CTR的患者的长期效果与仅接受择期CTR的患者相同。当在桡骨远端ORIF的同时进行CTR时,患者主观神经功能从急性正中神经功能障碍中的恢复情况应与仅接受择期CTR的患者相似。

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