Smits Arjen J, Giannakopoulos Georgios F, Zuidema Wietse P
Department of Surgery, VU University Medical Centre, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands.
Department of Surgery, Slotervaart Hospital, Louwesweg 6, 1066 EC Amsterdam, The Netherlands.
Injury. 2014 Oct;45(10):1564-8. doi: 10.1016/j.injury.2014.05.034. Epub 2014 Jun 5.
This study assessed the long-term outcome (>6 months, with a mean of 46 months after injury) of the conservatively treated radial head fracture type 1 of the Broberg-Morrey (B-M) modification of the Mason classification. The main aim of this study is to assess the limitations in ADL activities on long term following a conservative treatment for B-M 1 radial head fractures.
Out of a total patient group of 312 patients, 94 patients responded to our invitation for participation in the long-term follow-up study. These patients were included with a mean age of 42 years at time of injury and average of 46 months after injury. Most patients were treated with an upper arm cast or pressure bandage. These 94 patients were invited to fill out the validated Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire for elbow functioning as well as a demographic questionnaire. Basic patient and treatment data were collected from the hospital and trauma registration systems.
Forty-two percent of patients scored 0 (no disabilities) on the DASH questionnaire, 38% had a DASH score between 0.1 and 10.1, and 20% scored over 10.1. Correlations of the non-operative treatment modalities; immobilisation type, physiotherapy, smoking at time of injury, injury mechanism and immobilisation period with DASH outcome have not been found.
It appears that a B-M type 1 radial head fracture is not always accompanied with regaining full function on long term. To what extent these observed limitations influence patient behaviour and how treatment modalities influence these limitations should be the base of future prospective research.
本研究评估了采用保守治疗的梅森分类法中Broberg-Morrey(B-M)改良1型桡骨头骨折的长期预后(>6个月,受伤后平均46个月)。本研究的主要目的是评估保守治疗B-M 1型桡骨头骨折后长期日常生活活动(ADL)的受限情况。
在总共312例患者中,94例患者回应了我们参与长期随访研究的邀请。这些患者纳入研究时的平均年龄为42岁,受伤后平均46个月。大多数患者采用上臂石膏或加压绷带治疗。邀请这94例患者填写经过验证的用于评估肘部功能的上肢、肩部和手部功能障碍(DASH)问卷以及一份人口统计学问卷。从医院和创伤登记系统收集患者的基本资料和治疗数据。
42%的患者在DASH问卷上得分为0(无功能障碍),38%的患者DASH评分在0.1至10.1之间,20%的患者评分超过10.1。未发现非手术治疗方式(固定类型、物理治疗、受伤时吸烟、损伤机制和固定时间)与DASH预后之间存在相关性。
似乎B-M 1型桡骨头骨折长期并不总是能完全恢复功能。这些观察到的功能受限在多大程度上影响患者行为以及治疗方式如何影响这些受限情况,应成为未来前瞻性研究的基础。