Marinković Marija, Janjić Zlata, Nikolić Jelena
Vojnosanit Pregl. 2015 Feb;72(2):155-9. doi: 10.2298/vsp1502155m.
BACKGROUND/AIM: Hand injuries comprise up to one fourth of all injuries and require excellent skills and aggressive physical therapy with still a high potential to cause long term physical and functional disability which affects one's quality of life. The aim of this study was to evaluate disability and quality of life in patients with different degrees of hand and forearm injuries using the two different scoring sistems and to examine the correlation between them.
This retrospective study was performed among patients operated on at our clinic due to acute hand and forearm trauma during the period of two years. Four groups of patients were made according to the Modified Hand Injury Severity Score (MHISS). One year after the treatment, phone interviews were made with those patients to answer to the Disability of Arm Shoulder and Hand (quick-DASH) score for estimating disability and to the World Health Organization Quality of Life BREF (WHOQoL-BREF) score to estimate the quality of life regerding four domains: physical, social, environmental and psychological.
Out of 182 patients who satisfied the inclusion criteria, only 60 completely answered to the questionnaires, 46 (17%) men and 14 (23%) women. Most of the patients were in the group with moderate injuries according to the MHISS, followed by the group with major and severe injuries. A weak correlation was found between the MHISS and quick DASH score in the group with minor injuries, compared to no correlation between these parameters in other groups. The lowest quality of life was registered in the physical domain, while the highest in the social one. A negative correlation was found among the four domains of the WHOQoL BREF score and quick-DASH score in all the groups.
Severity of hand and forearm injuries does not necessarily correlate with patient's perception of disability. The quality of life was less affected by severity of injury than by the patient's per- ception of disability.
背景/目的：手部损伤占所有损伤的四分之一，需要精湛的技术和积极的物理治疗，但仍有很高的可能性导致长期身体和功能残疾，影响生活质量。本研究的目的是使用两种不同的评分系统评估不同程度手部和前臂损伤患者的残疾情况和生活质量，并研究它们之间的相关性。
本回顾性研究在两年内因急性手部和前臂创伤在我们诊所接受手术的患者中进行。根据改良手部损伤严重程度评分（MHISS）将患者分为四组。治疗一年后，对这些患者进行电话访谈，以回答手臂、肩部和手部残疾（快速DASH）评分以评估残疾情况，并回答世界卫生组织生活质量简表（WHOQoL-BREF）评分以评估四个领域的生活质量：身体、社会、环境和心理。
在182名符合纳入标准的患者中，只有60名完全回答了问卷，其中46名（17%）男性和14名（23%）女性。根据MHISS，大多数患者属于中度损伤组，其次是重度和极重度损伤组。在轻伤组中，MHISS与快速DASH评分之间存在弱相关性，而在其他组中这些参数之间无相关性。生活质量最低的是身体领域，最高的是社会领域。在所有组中，WHOQoL BREF评分的四个领域与快速DASH评分之间均存在负相关。
手部和前臂损伤的严重程度不一定与患者的残疾感知相关。生活质量受损伤严重程度的影响小于受患者残疾感知的影响。
