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桡骨远端骨折术后早期QuickDASH评分的改善与手术治疗方式有关。

Early postoperative improvements in the QuickDASH score after distal radius fracture are related to the type of surgical treatment.

作者信息

Loisel François, Bouilloux Xavier, Uhring Julien, Rochet Séverin, Obert Laurent

机构信息

Service d'Orthopédie, de Traumatologie, de Chirurgie Plastique, Reconstructrice et Assistance Main & CIC IT 808, EA 4268 Innovation, Imagerie, Ingénierie et Intervention en santé « I4S » IFR 133 INSERM, C.H.U. Besançon, 25033, Besançon, France,

出版信息

Eur J Orthop Surg Traumatol. 2015 Jul;25(5):865-9. doi: 10.1007/s00590-015-1626-1. Epub 2015 Apr 18.

Abstract

The goal of this prospective study was to evaluate the real-life experience of 52 patients and their recovery kinetics in the first 6 weeks after surgical treatment of distal radius fractures. The fractures were treated with either a fourth-generation volar locking plate (34 patients, mean age 67 years, range 54-82) or by percutaneous pinning (18 patients, mean age 56 years, range 43-69). These patients were evaluated every week for 6 weeks with the QuickDASH (QD) questionnaire. A lower QD score indicated that the patient's physical function and symptoms had improved. At postoperative week 1, all the patients who had undergone percutaneous pinning had a QD of 80 (out of 100). One-third of patients who had undergone plate fixation had a QD of 80, while the remainder had a QD of 65. Out of all the patients who had a QD of 80 at postoperative week 1, the patients who had undergone plate fixation improved more quickly. After 6 weeks, the patients who had undergone plate fixation had a greater reduction in the QD (50 points) than the ones who had undergone pinning (30 points). Although the direct costs of locking plate fixation are 10 times higher than those of K-wire pinning, evidence suggests that these plates reduce the indirect costs. This study has shown that a patient's recovery rate, day-to-day life and physical function are better over the first 6 weeks postsurgery when the distal radius fracture is fixed with a locking plate.

摘要

这项前瞻性研究的目的是评估52例患者在桡骨远端骨折手术治疗后的6周内的实际生活体验及其恢复动力学。骨折患者分别接受了第四代掌侧锁定钢板治疗(34例,平均年龄67岁,范围54 - 82岁)或经皮穿针治疗(18例,平均年龄56岁,范围43 - 69岁)。使用QuickDASH(QD)问卷对这些患者进行了为期6周的每周评估。较低的QD评分表明患者的身体功能和症状有所改善。术后第1周,所有接受经皮穿针治疗的患者的QD评分为80(满分100)。接受钢板固定的患者中有三分之一的QD评分为80,其余患者的QD评分为65。在术后第1周QD评分为80的所有患者中,接受钢板固定的患者改善得更快。6周后,接受钢板固定的患者的QD评分降低幅度(50分)大于接受穿针治疗的患者(30分)。尽管锁定钢板固定的直接成本比克氏针固定高10倍,但有证据表明这些钢板降低了间接成本。这项研究表明,在桡骨远端骨折采用锁定钢板固定后的术后6周内,患者的恢复率、日常生活和身体功能更好。

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