Kruithof Ronnart N, Formijne Jonkers Henk A, van der Ven Denise J C, van Olden Ger D J, Timmers Tim K
Department of Surgery, Meander Medical Center Amersfoort, P.O.-box 1502, 3800 BM, Amersfoort, The Netherlands.
J Orthop Traumatol. 2017 Dec;18(4):423-430. doi: 10.1007/s10195-017-0468-5. Epub 2017 Aug 22.
Fractures of the proximal humerus are common and most often treated non-operatively. However, long-term follow-up studies focusing on functional results and quality of life in patients after this type of fracture are scarce. The primary aim of this study is to report the long-term functional and quality of life outcome in patients with a proximal humeral fracture.
A retrospective analysis of all consecutive patients undergoing non-operative treatment for a proximal humeral fracture in a level 2 trauma centre between January 2000 and December 2013 was performed. A database consisting of all relevant demographic, patient and fracture characteristics was created. Subsequently, a questionnaire containing the DASH (Disabilities of the Arm, Shoulder and Hand) score, EuroQol-5D (EQ-5D), VAS (visual analogue scale) score, and subjective questions was sent to all patients.
A total of 410 patients (65 male, 345 female) were included for analyses. Average follow-up was 90 ± 48 months. DASH-scores <15 were considered as good. A median DASH-score of 6.67 [0.83-22.50] was found. A significant lower DASH-score was seen in patients under the age of 65 compared to older patients (p < 0.001). In comparison to an age-matched general Dutch population, Health related Quality of Life (HrQoL) on the EQ-us was not significantly worse in our study population (difference 0.02). Strong (negative) correlation was found between DASH-score and VAS-score, and DASH-score and HrQoL, respectively ρ = -0.534 and ρ = -0.787.
Long-term functional and quality of life outcomes are good in most patients after proximal humeral fractures, but negatively correlated to each other.
Level III.
肱骨近端骨折很常见，大多采用非手术治疗。然而，针对此类骨折患者功能结果和生活质量的长期随访研究较少。本研究的主要目的是报告肱骨近端骨折患者的长期功能及生活质量结果。
对2000年1月至2013年12月期间在一家二级创伤中心接受肱骨近端骨折非手术治疗的所有连续患者进行回顾性分析。创建了一个包含所有相关人口统计学、患者及骨折特征的数据库。随后，向所有患者发送了一份包含上肢、肩部和手部功能障碍（DASH）评分、欧洲五维健康量表（EQ-5D）、视觉模拟量表（VAS）评分以及主观问题的问卷。
共纳入410例患者（男性65例，女性345例）进行分析。平均随访时间为90±48个月。DASH评分<15被认为良好。发现DASH评分中位数为6.67[0.83 - 22.50]。65岁以下患者的DASH评分显著低于老年患者（p<0.001）。与年龄匹配的荷兰普通人群相比，本研究人群在EQ-5D上的健康相关生活质量（HrQoL）并无显著更差（差异为0.02）。分别发现DASH评分与VAS评分以及DASH评分与HrQoL之间存在强（负）相关性，相关系数分别为ρ = -0.534和ρ = -0.787。
大多数肱骨近端骨折患者的长期功能和生活质量结果良好，但两者呈负相关。
三级。
