Christiano A, Pean C A, Konda S, Egol K A
Acta Orthop Belg. 2017 Mar;83(1):1-7.
The purpose is to identify risk factors of functional outcome following proximal humerus open reduction and internal fixation. Patients treated for proximal humerus fractures with open reduction and internal fixation were enrolled in a prospective data registry. Patients were evaluated for function using the Disability of the Arm, Shoulder and Hand score for 12 months and as available beyond 12 months. Univariate analyses were conducted to identify variables associated with functional outcome. Significant variables were included in a multivariate regression predicting functional outcome. Demographics and minimum of 12 month follow-up were available for 129 patients (75%). Multiple regression demonstrated postoperative complication (B=8.515 p=0.045), education level (B=-6.269p<0.0005), age (B=0.241p=0.049) and Charlson Comorbidity Index (B=6.578, p=0.001) were all significant predictors of functional outcome. Orthopaedic surgeons can use education level, comorbidities, age, and postoperative complication information to screen patients for worse outcomes, establish expectations, and guide care.
目的是确定肱骨近端切开复位内固定术后功能预后的危险因素。接受肱骨近端骨折切开复位内固定治疗的患者被纳入前瞻性数据登记。使用手臂、肩部和手部功能障碍评分对患者进行为期12个月的功能评估，并在12个月后尽可能继续评估。进行单因素分析以确定与功能预后相关的变量。显著变量被纳入预测功能预后的多因素回归分析。129例患者（75%）有可供分析的人口统计学资料及至少12个月的随访数据。多因素回归分析表明，术后并发症（B = 8.515，p = 0.045）、教育水平（B = -6.269，p < 0.0005）、年龄（B = 0.241，p = 0.049）和Charlson合并症指数（B = 6.578，p = 0.001）均为功能预后的显著预测因素。骨科医生可利用教育水平、合并症、年龄和术后并发症信息，对预后较差的患者进行筛查，设定预期，并指导治疗。
