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锤状指损伤“自我护理”方案的功能结局与满意度:病例系列研究

Functional outcome and satisfaction with a "self-care" protocol for the management of mallet finger injuries: a case-series.

作者信息

Brooksbank Katriona, Jenkins Paul J, Anthony Iain C, Gilmour Alisdair, Nugent Margaret P, Rymaszewski Lech A

机构信息

Department of Orthopaedic Surgery, Glasgow Royal Infirmary, 84 Castle Street, Glasgow, G4 0SF UK.

出版信息

J Trauma Manag Outcomes. 2014 Dec 10;8(1):21. doi: 10.1186/s13032-014-0021-y. eCollection 2014.

Abstract

BACKGROUND

Mallet finger injuries are usually successfully treated non-operatively with a splint. Most patients are reviewed at least twice in a clinic after the initial presentation in A&E. A new protocol promoting "self-care" was introduced at our institution. Patients were provided with structured verbal and written information, and given access to a telephone helpline.

METHODS

A prospective electronic patient record was used to identify all patients who presented to the emergency department with a mallet finger with a minimum six month follow-up. A satisfaction and patient reported outcome measure was administered via a postal questionnaire. The response rate was 36/47 (77%).

RESULTS

The median QuickDASH score was 2.3 (IQR 0 to 4.6). All patients were satisfied with the treatment plan provided. Nine used the helpline and all were satisfied with information given. Although 13 patients reported some extensor lag, or bump, they had no functional limitation. Seven patients were reviewed by the general practitioner or other clinicians during their treatment period for issues such a skin care, splint size changes or sickness certification. Five were subsequently reviewed at the end of their treatment period in a clinic at their request, or their general practitioner, but did not require further surgical intervention.

CONCLUSIONS

Self-care for mallet finger injuries, with adequate patient information and telephone back-up, leads to acceptable functional results and satisfaction.

LEVEL OF EVIDENCE

III.

摘要

背景

槌状指损伤通常通过夹板进行非手术治疗即可成功治愈。大多数患者在急诊科初次就诊后至少在门诊接受两次复查。我们机构引入了一项促进“自我护理”的新方案。为患者提供了结构化的口头和书面信息,并让他们能够拨打热线电话。

方法

使用前瞻性电子病历识别所有因槌状指到急诊科就诊且随访至少6个月的患者。通过邮寄问卷进行满意度和患者报告结局测量。回复率为36/47(77%)。

结果

QuickDASH评分中位数为2.3(四分位间距0至4.6)。所有患者对提供的治疗方案均满意。9人使用了热线电话,所有人对所提供的信息均满意。尽管13名患者报告存在一些伸肌滞后或肿块,但他们没有功能受限。7名患者在治疗期间因皮肤护理、夹板尺寸变化或疾病证明等问题由全科医生或其他临床医生进行了复查。5名患者随后应其要求或经全科医生安排在治疗期结束时在门诊接受了复查,但无需进一步手术干预。

结论

对于槌状指损伤的自我护理,在为患者提供充分信息并给予电话支持的情况下,可取得可接受的功能结果并获得患者满意。

证据水平

Ⅲ级。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/00f6/4266946/9b8669c8ccdd/13032_2014_21_Fig1_HTML.jpg

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