MacIntyre Norma J, Dewan Neha
School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada.
School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada.
J Hand Ther. 2016 Apr-Jun;29(2):136-45. doi: 10.1016/j.jht.2016.03.003.
Literature Review.
For optimal Distal Radius Fracture (DRF) rehabilitation and fracture prevention, it is important to understand the epidemiology and factors predictive of injury, chronic pain, chronic disability, and subsequent fracture.
To summarize the literature reporting on DRF epidemiology, risk factors, and prognostic factors.
Literature synthesis.
Although incidence varies globally, DRFs are common across the lifespan and appear to be on the rise. Risk of DRF is determined by personal factors (age, sex/gender, lifestyle, health condition) and environmental factors (population density, climate). For example, age and sex influence risk such that DRF is most common in boys/young men and older women. The most common causes of DRF in the pediatric and young adult age groups include playing/sporting activities and motor vehicle accidents. In contrast, the most common mechanism of injury in older adults is a low-energy trauma because of a fall from a standing height. Poorer health outcomes are associated with older age, being female, poor bone healing (or having an associated fracture of the ulnar styloid), having a compensated injury, and a lower socioeconomic status.
Risk stratification according to predictors of chronic pain and disability enable therapists to identify those patients who will benefit from advocacy for more comprehensive assessment, targeted interventions, and tailored educational strategies. The unique opportunity for secondary prevention of osteoporotic fracture after DRF has yet to be realized by treating therapists in the orthopedic community.
V.
文献综述。
为实现桡骨远端骨折(DRF)的最佳康复及预防骨折,了解其流行病学以及损伤、慢性疼痛、慢性残疾和后续骨折的预测因素非常重要。
总结关于DRF流行病学、危险因素和预后因素的文献报道。
文献综合分析。
尽管全球发病率有所不同,但DRF在整个生命周期中都很常见,且有上升趋势。DRF的风险由个人因素(年龄、性别、生活方式、健康状况)和环境因素(人口密度、气候)决定。例如,年龄和性别会影响风险,DRF在男孩/年轻男性和老年女性中最为常见。儿童和年轻成人年龄组中DRF最常见的原因包括玩耍/体育活动和机动车事故。相比之下,老年人最常见的损伤机制是从站立高度跌落导致的低能量创伤。较差的健康结局与年龄较大、女性、骨折愈合不良(或伴有尺骨茎突骨折)、有代偿性损伤以及社会经济地位较低有关。
根据慢性疼痛和残疾的预测因素进行风险分层,可使治疗师识别出那些将从倡导更全面评估、针对性干预和量身定制的教育策略中受益的患者。骨科领域的治疗师尚未认识到DRF后骨质疏松性骨折二级预防的独特机会。
V级。