Plant C E, Parsons N R, Costa M L
University of Warwick, Coventry, CV4 7AL, UK.
NDORMS, University of Oxford, John Radcliffe Hospital, Oxford, UK.
Bone Joint J. 2017 Mar;99-B(3):376-382. doi: 10.1302/0301-620X.99B3.35819.
We conducted a study to determine whether radiological parameters correlate with patient reported functional outcome, health-related quality of life and physical measures of function in patients with a fracture of the distal radius.
The post-operative palmar tilt and ulnar variance at six weeks and 12 months were correlated with the Patient Rated Wrist Evaluation, Disabilities of the Arm, Shoulder and Hand, and EuroQol scores, grip strength, pinch strength and range of movement at three, six and 12 months for 50 patients (mean age 57 years; 26 to 85) having surgical fixation, with either percutaneous pinning or reconstruction with a volar plate, for a fracture of the distal radius.
Radiological parameters were found to correlate poorly with the patient reported outcomes (r = 0.00 to 0.47) and physical measures of function (r = 0.01 to 0.51) at all intervals.
This study raises concerns about the use of radiological parameters to determine management, and to act as a surrogates for successful treatment, in patients with a fracture of the distal radius. Restoration of 'normal' radiographic parameters may not be necessary to achieve a satisfactory functional outcome for the patient. Cite this article: 2017;99-B:376-82.
我们开展了一项研究,以确定桡骨远端骨折患者的影像学参数与患者报告的功能结局、健康相关生活质量及功能的物理测量指标之间是否存在相关性。
对50例(平均年龄57岁,26至85岁)接受手术固定(采用经皮穿针或掌侧钢板重建)治疗桡骨远端骨折的患者,测量其术后6周和12个月时的掌倾角和尺骨变异,并将其与患者腕关节评估评分、上肢、肩部和手部功能障碍评分、欧洲五维健康量表评分、3个月、6个月和12个月时的握力、捏力及活动范围进行相关性分析。
在所有时间点,影像学参数与患者报告的结局(r = 0.00至0.47)及功能的物理测量指标(r = 0.01至0.51)之间的相关性均较差。
本研究引发了对于在桡骨远端骨折患者中使用影像学参数来确定治疗方案及作为成功治疗替代指标的担忧。恢复“正常”的影像学参数对于患者获得满意的功能结局可能并非必要。引用本文:2017;99-B:376-82。