Cocco Luiz Fernando, Ejnisman Benno, Belangero Paulo Santoro, Cohen Moises, Dos Reis Fernando Baldy
Department of Orthopedics and Traumatology, (DOT/UNIFESP)-Escola Paulista de Medicina, Universidade Federal de São Paulo, Rua Borges Lagoa, 778, São Paulo, SP CEP 04024-002 Brazil.
Patient Saf Surg. 2018 Mar 12;12:4. doi: 10.1186/s13037-018-0150-8. eCollection 2018.
The treatment of humeral fractures remains controversial. Systematic reviews demonstrate similar results between dynamic compression plating and locked intramedullary nailing in the surgical treatment of these fractures. However, it appears that antegrade intramedullary nailing causes higher residual pain in the shoulder. The proposal of this work is to evaluate through the WORC protocol (Western Ontario Rotator Cuff Index) the consequences in the quality of life of patients submitted to osteosynthesis of the humerus with antegrade locked intramedullary nailing.
This work is a cohort retrospective study in addition to the application of a questionnaire for self-rated quality of life with its 05 domains (WORC - Western Ontario Rotator Cuff Index) for patients ( = 26) classified in the Trauma Sector of the Department of Orthopedics and Traumatology of the Federal University of São Paulo (DOT/UNIFESP) submitted to Humerus Osteosynthesis with Antegrade Locked Intramedullary Nailing. There was also the inclusion of data related to the time since surgery, age, sex, surgical laterality, dominance among members and work leave, which were not considered in the original protocol. After, the data were statistically assessed to evaluate the association between numerical and categorical variables.
The overall WORC score was 82.75 ± 17.00 (Mean ± SD) and was not different considering sex, age and postoperative period. Among the WORC domains, both Work and Sport / Recreation Protocols were the most unfavorable factors in the evaluation of patients. Although not statistically significant, those who had the procedure on the dominant side presented a lower quality of life score than those who had the surgery on the non-dominant side. Although non-significant again, those who were away from work had an overall lower quality of life score than those who were not.
The WORC Quality of Life Protocol shows good results for evaluating patients submitted to humerus osteosynthesis with antegrade locked intramedullary nailing. The data stratified by domains were good, however, Work and Sport/Recreation domains showed the lowest means compared to the other domains.
Research Ethics Commitee (CEP 0676/2016) and Plataforma Brasil 56381216.3.0000.550. CAAE: 56381216.3.0000.5505.
肱骨骨折的治疗仍存在争议。系统评价表明,动力加压钢板和锁定髓内钉在这些骨折的手术治疗中效果相似。然而,顺行髓内钉似乎会导致肩部残留疼痛加剧。本研究的目的是通过WORC协议(西安大略肩袖指数)评估接受顺行锁定髓内钉肱骨内固定术的患者生活质量所受的影响。
本研究是一项队列回顾性研究,除了应用一份自评生活质量问卷及其5个领域(WORC - 西安大略肩袖指数),对圣保罗联邦大学骨科与创伤科创伤科(DOT/UNIFESP)接受顺行锁定髓内钉肱骨内固定术的患者(n = 26)进行调查。还纳入了与手术时间、年龄、性别、手术侧别、肢体优势和工作休假相关的数据,这些数据在原始协议中未被考虑。之后,对数据进行统计学评估,以评估数值变量和分类变量之间的关联。
WORC总分82.75±17.00(均值±标准差),在性别、年龄和术后时期方面无差异。在WORC各领域中,工作和运动/娱乐项目是评估患者时最不利的因素。虽然无统计学意义,但在优势侧进行手术的患者生活质量得分低于非优势侧手术的患者。同样无统计学意义的是,休假的患者总体生活质量得分低于未休假的患者。
WORC生活质量协议在评估接受顺行锁定髓内钉肱骨内固定术的患者时显示出良好的效果。按领域分层的数据良好,然而,与其他领域相比,工作和运动/娱乐领域的均值最低。
研究伦理委员会(CEP 0676/2016)和巴西平台56381216.3.0000.550。CAAE:56381216.3.0000.5505。