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肱骨干骨折的主要早期结局指标:一项拉丁美洲多中心前瞻性研究。

Quick-DASH as a main early outcome of humeral shaft fractures: A Latin American multicenter prospective study.

机构信息

Orthopaedics and Traumatology Department, School of Medical Sciences, University of Campinas, Brazil.

Trauma Department, Police Hospital Churruca-Visca, Buenos Aires, Argentina.

出版信息

J Orthop Surg (Hong Kong). 2020 Jan-Apr;28(2):2309499020929436. doi: 10.1177/2309499020929436.

Abstract

PURPOSE

The main objective of this study was to evaluate the Quick-Disabilities of the Arm, Shoulder and Hand Score (DASH) score as the main early (90 days) outcome in a prospective multicenter observational Latin American study on isolated humeral shaft fractures.

METHODS

From December 2015 to April 2017, in six Latin American countries, patients 18 years or older with a closed, isolated nonpathological 12A, 12B, or 12C AO/OTA (Arbeitsgemeinschaft für Osteosynthesefragen/Orthopaedic Trauma Association) fractures were included. The 90 (±10)-day Quick-DASH score was used to compare the results of the different treatments. The secondary outcomes were patient treatment satisfaction, shoulder and elbow range of motion, and radiographic evaluation.

RESULTS

A total of 92 patients successfully completed the Quick-DASH questionnaire. Surgical treatments resulted in better outcomes than nonsurgical treatment, but only minimally invasive plate osteosynthesis produced significantly lower Quick-DASH scores than nonsurgical treatment ( < 0.05). There were strong correlations between patient self-evaluation and the Quick-DASH score ( < 0.0005) but not between the Quick-DASH score and radiographic fracture healing. No significant difference was found between the treatments regarding the rate of return to work, but the medical center had a significant influence on treatment choice ( < 0.0005).

CONCLUSION

The high correlation between Quick-DASH score and patient satisfaction and functional outcome indicates that the Quick-DASH questionnaire is a suitable tool for evaluating adult humeral shaft fracture outcomes. Patients with a Quick-DASH score below 15 could be considered recovered, and patients with a Quick-DASH score above 40 could be considered not yet recovered. Quick-DASH scores were not significantly associated with radiographic fracture healing.

摘要

目的

本研究的主要目的是评估快速上肢、肩部和手部残疾(DASH)评分作为前瞻性多中心观察性拉丁美洲单纯肱骨干骨折的主要早期(90 天)结果。

方法

2015 年 12 月至 2017 年 4 月,在六个拉丁美洲国家,纳入 18 岁或以上的闭合性、孤立性、非病理性 12A、12B 或 12C AO/OTA(骨与关节创伤协会)骨折患者。使用 90(±10)天快速 DASH 评分比较不同治疗方法的结果。次要结局为患者治疗满意度、肩肘活动范围和影像学评估。

结果

共有 92 例患者成功完成快速 DASH 问卷。手术治疗的结果优于非手术治疗,但只有微创钢板接骨术的快速 DASH 评分显著低于非手术治疗(<0.05)。患者自我评估与快速 DASH 评分之间存在很强的相关性(<0.0005),但与影像学骨折愈合之间没有相关性。治疗方法之间在恢复工作的比例方面没有显著差异,但医疗中心对治疗选择有显著影响(<0.0005)。

结论

快速 DASH 评分与患者满意度和功能结果之间的高度相关性表明,快速 DASH 问卷是评估成人肱骨干骨折结果的合适工具。快速 DASH 评分为 15 分以下的患者可视为痊愈,快速 DASH 评分为 40 分以上的患者可视为未痊愈。快速 DASH 评分与影像学骨折愈合无显著相关性。

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