From the Orthopedic Surgery Department, University of Puerto Rico (UPR) Medical Sciences Campus, San Juan, Puerto Rico (Dr. Rodríguez-Pérez, Dr. Dávila-Parrilla, Dr. Rivera, Dr. Olivella, Dr. Muñiz, and Dr. Lojo-Sojo), and Pediatric Orthopedic Department, Mayagüez Medical Center, Mayagüez, Puerto Rico (Dr. Ramírez).
J Am Acad Orthop Surg Glob Res Rev. 2020 Oct 1;4(10):e20.00162. doi: 10.5435/JAAOSGlobal-D-20-00162.
Demographic and socioeconomic factors are important determinants that may affect patient self-reported outcomes after acetabular fracture surgery. Hispanics, as a minority group, have an increased tendency to suffer demographic and socioeconomic disparities. At the present time, there is scant information regarding their role among Hispanic patients with acetabular fractures. The aim of this study was to investigate whether demographic or socioeconomic factors would affect satisfaction and self-reported functional outcomes in Hispanic patients who endured open reduction and internal fixation (ORIF) of posterior wall fractures of the acetabulum.
A cross-sectional study of 78 patients with posterior wall fracture of the acetabulum treated with ORIF from 2011 to 2017 was performed. Data from demographics (age, sex, and body mass index [BMI]) and socioeconomic factors (household income, highest educational level achieved, employment status, type of medical insurance, workers' compensation involvement, and injury-related litigation process) were obtained and compared with the Short Musculoskeletal Form Assessment-46 (SMFA-46) questionnaire using a multivariable logistic regression analysis.
Unemployment was the most significant variable associated with dissatisfaction among 15 of the 46 responses of the SMFA-46 (P < 0.048). Patients who had an overweight or obese BMI and had an age of 41 years or older exhibited significantly worse outcomes in 7 of the 46 questions (P < 0.049). Finally, women were less likely to be satisfied in 1 of the 46 questions (P = 0.028). No notable difference was observed in any of the SMFA-46 responses regarding insurance plan, educational level, workers' compensation involvement, and injury-related litigation process.
A strong association exists between dissatisfaction after ORIF of posterior wall fractures of the acetabulum and employment status, BMI, and age among the Hispanic population. Addressing socioeconomic factors can be critical to overcome dissatisfaction and improve functional status among Hispanic patients with acetabular fractures.
人口统计学和社会经济学因素是重要的决定因素，可能会影响髋臼骨折手术后患者的自我报告结果。西班牙裔作为少数群体，存在人口统计学和社会经济学差异的倾向增加。目前，关于西班牙裔髋臼骨折患者中他们的作用的信息很少。本研究旨在探讨在接受髋臼后侧壁切开复位内固定术（ORIF）治疗的西班牙裔患者中，人口统计学或社会经济学因素是否会影响他们的满意度和自我报告的功能结果。
对 2011 年至 2017 年期间接受 ORIF 治疗的 78 例髋臼后侧壁骨折患者进行了一项横断面研究。收集人口统计学（年龄、性别和体重指数 [BMI]）和社会经济学因素（家庭收入、最高学历、就业状况、医疗保险类型、工人赔偿参与情况和与伤害相关的诉讼程序）的数据，并使用多变量逻辑回归分析与 Short Musculoskeletal Form Assessment-46（SMFA-46）问卷进行比较。
在 SMFA-46 的 46 个回答中有 15 个回答中，失业是最显著的与不满意相关的变量（P < 0.048）。超重或肥胖 BMI 且年龄为 41 岁或以上的患者在 7 个 46 个问题中的表现明显较差（P < 0.049）。最后，女性在 46 个问题中的 1 个问题中不太可能满意（P = 0.028）。在任何 SMFA-46 反应中，都没有观察到保险计划、教育水平、工人赔偿参与和与伤害相关的诉讼程序的显著差异。
在西班牙裔人群中，髋臼后侧壁切开复位内固定术后不满意与就业状况、BMI 和年龄之间存在很强的关联。解决社会经济学因素对于克服西班牙裔髋臼骨折患者的不满并改善其功能状态至关重要。
