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60岁以上桡骨远端骨折患者影像学参数与功能预后的相关性

Correlation Between Radiological Parameters and Functional Outcomes in Patients Older Than 60 Years of Age With Distal Radius Fracture.

作者信息

Gutiérrez-Monclus Rodrigo, Gutiérrez-Espinoza Héctor, Zavala-González Jonathan, Olguín-Huerta Cristian, Rubio-Oyarzún David, Araya-Quintanilla Felipe

机构信息

Hand Team of Traumatology Institute of Santiago, Chile.

University of the Americas, Santiago, Chile.

出版信息

Hand (N Y). 2019 Nov;14(6):770-775. doi: 10.1177/1558944718770203. Epub 2018 Apr 17.

Abstract

The relationship between radiographic and functional outcomes is controversial in the elderly. The objective of this study is to determine whether there is a correlation between functional outcome and acceptable distal radius fracture (DRF) alignment in patients older than 60 years of age. This correlation study was carried out at the Central Metropolitan Health Service of Chile. A total of 180 patients diagnosed with extra-articular DRF, according to the AO classification, were prospectively recruited. Radiological parameters, including radial inclination, residual dorsal angulation, ulnar variance, and articular step-off, were evaluated to assess the results of orthopedic reduction. Functional outcome was assessed immediately following cast removal and again at the 6-month follow-up. The Disabilities of the Arm, Shoulder and Hand (DASH) and Patient-Rated Wrist Evaluation (PRWE) questionnaires were administered to assess upper extremity function, and the visual analog scale (VAS) was used to assess pain intensity. Only 68 patients (37.8%) showed acceptable DRF alignment. After cast removal, the correlations between alignment and the functional outcome measures were as follows: DASH 0.071 ( = .546), PRWE 0.03 ( = .823), and VAS 0.12 ( = .631). At the 6-month follow-up, the correlations between alignment and the functional outcome measures were as follows: DASH 0.029 ( = .768), PRWE 0.014 ( = .895), and VAS 0.09 ( = .614). There was no significant correlation between acceptable alignment according to radiological parameters and short- or medium-term functional outcome in patients older than 60 years with extra-articular DRF treated conservatively.

摘要

在老年人中,影像学结果与功能预后之间的关系存在争议。本研究的目的是确定60岁以上患者的功能预后与可接受的桡骨远端骨折(DRF)对线之间是否存在相关性。这项相关性研究在智利首都中央卫生服务中心开展。根据AO分类法,前瞻性招募了总共180例诊断为关节外DRF的患者。评估包括桡骨倾斜度、残余背侧成角、尺骨变异和关节台阶等放射学参数,以评估骨科复位的结果。在拆除石膏后立即评估功能预后,并在6个月随访时再次评估。采用手臂、肩部和手部功能障碍(DASH)问卷和患者自评腕关节评估(PRWE)问卷评估上肢功能,采用视觉模拟量表(VAS)评估疼痛强度。只有68例患者(37.8%)显示DRF对线可接受。拆除石膏后,对线与功能预后指标之间的相关性如下:DASH为0.071(P = 0.546),PRWE为0.03(P = 0.823),VAS为0.12(P = 0.631)。在6个月随访时,对线与功能预后指标之间的相关性如下:DASH为0.029(P = 0.768),PRWE为0.014(P = 0.895),VAS为0.09(P = 0.614)。对于采用保守治疗的60岁以上关节外DRF患者,根据放射学参数的可接受对线与短期或中期功能预后之间无显著相关性。

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