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经皮固定后骨盆环后,无症状患者的功能是否正常?一项病例对照试点研究。

Do asymptomatic patients have normal function after percutaneous fixation of the posterior pelvic ring? A case-control pilot study.

作者信息

Salari Pooria, Cannada Lisa K, Moed Berton R

机构信息

Department of Orthopaedic Surgery, Saint Louis University School of Medicine, 3635 Vista Avenue, 7th Floor Desloge Towers, St. Louis, MO, 63110, USA.

出版信息

J Orthop Surg Res. 2015 May 16;10:68. doi: 10.1186/s13018-015-0190-z.

Abstract

BACKGROUND

Following treatment of a posterior pelvic disruption, residual deformity or associated injuries can adversely affect functional recovery. No study has been performed on gait and functional outcome after closed reduction and percutaneous screw fixation (CRPSF) of posterior pelvic disruption in clinically asymptomatic patients. The purpose of this study was to determine if gait and functional outcome are different from normal in asymptomatic patients with a posterior pelvic injury after CRPSF, serving as a pilot study in this regard.

METHODS

Six asymptomatic patients with no grossly evident gait abnormality, treated by CRPSF for a posterior pelvic disruption, were included in the study (SG). A control group (CG) of six healthy volunteers was created. All participants completed the 12-Item Short Form Health Survey version 2 (SF-12v2), the Majeed Pelvic Score (MPS), and the Iowa Pelvic Score (IPS). In addition, the participants' gait was analyzed.

RESULTS

Pelvic drop was significantly smaller on the uninjured side in the SG when compared to the injured side in the SG. There was no significant difference between the injured and uninjured side for other gait parameters within the SG. Knee angle at initial contact was significantly greater on the injured side when compared to the CG. The SG scored statistically worse than the CG on the Physical Component Summary part of the SF-12v2. However, when evaluated by age group using national mean scores, the SG differences were minimal. All six patients in our study scored "excellent" on both MPS and IPS.

CONCLUSIONS

Despite having subclinical alterations in gait, asymptomatic pelvic ring injured patients show minimal, if any, evidence of impaired functional outcome following successful reduction of a posterior pelvic disruption treated by CRPSF.

摘要

背景

骨盆后环损伤经治疗后,残留畸形或相关损伤会对功能恢复产生不利影响。对于临床无症状的骨盆后环损伤患者,在进行闭合复位经皮螺钉固定(CRPSF)后,尚未有关于步态和功能结局的研究。本研究的目的是确定在CRPSF治疗后,无症状骨盆后环损伤患者的步态和功能结局是否与正常情况不同,以此作为这方面的一项初步研究。

方法

本研究纳入了6例经CRPSF治疗骨盆后环损伤且无明显步态异常的无症状患者(研究组,SG)。设立了一个由6名健康志愿者组成的对照组(CG)。所有参与者均完成了12项简明健康调查量表第2版(SF - 12v2)、马吉德骨盆评分(MPS)和爱荷华骨盆评分(IPS)。此外,还对参与者的步态进行了分析。

结果

与研究组中受伤侧相比,研究组中未受伤侧的骨盆下降明显更小。研究组内受伤侧和未受伤侧的其他步态参数无显著差异。与对照组相比,研究组受伤侧初始接触时的膝关节角度明显更大。在SF - 12v2的身体成分总结部分,研究组的得分在统计学上低于对照组。然而,按年龄组使用全国平均得分进行评估时,研究组的差异很小。本研究中的6例患者在MPS和IPS上均得“优秀”。

结论

尽管步态存在亚临床改变,但无症状骨盆环损伤患者在成功复位经CRPSF治疗的骨盆后环损伤后,即使有功能结局受损的证据,也极为轻微。

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