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AO型肱骨远端C型骨折患者手术治疗后影响重返工作的因素分析

Analysis of Factors Affecting Return to Work After Surgical Treatment in Patients with AO Type C Distal Humerus Fractures.

作者信息

Kumbaraci Mert, Basa Can Doruk, Turgut Ali

机构信息

Orthopaedic and Traumatology Department, Orthopaedic Surgeon Tepecik Training and Research Hospital, Yenisehir, 35110 Izmir, Turkey.

出版信息

Indian J Orthop. 2020 Sep 19;55(3):680-687. doi: 10.1007/s43465-020-00260-x. eCollection 2021 Jun.

Abstract

BACKGROUND

The purpose of this study is to evaluate the functional results of distal humerus fractures which were treated by open reduction and fixation with pre-contoured angular stable plates in young patients, and investigate whether the patients could return to their pre-injury work and patients' financial conditions while they were not working.

MATERIALS AND METHODS

The data of 48 patients, ages between 18 and 55 years, working in a job and having AO/OTA type C distal humerus fracture were retrospectively evaluated. Mayo Elbow Performance Score (MEPS) was used to determine functional results. Postoperative radiographs were evaluated to determine the rate of union, degenerative changes, malunion and heterotopic ossification. Financial outcome form was constituted by the authors and the patients asked whether she/he could return to their pre-injury works after treatment finished and the financial status of the patients during the treatment and after the treatment.

RESULTS

The mean flexion-extension arc was 114° ± 12°(range 85°-135°) and the mean MEPS score was 85 ± 11(range 65-100). The average time to return to work was 6.5 ± 2.4 months (3-12 months). AO type C2 and C3 fractures and heterotopic ossification negatively affected the functional results and also adversely affected the patients' return to their pre-injury works. 38 (79%) patients returned to pre-injury work and 29 (76%) of them started to work at the same position before the fracture occured. Nine of 38 patients (24%) had to change their positions. Among the 48 patients, 10 patients (21%) could not return to the same work, 7 of them found light duty and 3 of them had not been to work.

CONCLUSION

Although the functional results of surgical treatment of intra-articular distal humerus fractures are good, at the end of the treatment, especially heavy workers may have difficulties in returning to their former works.

摘要

背景

本研究的目的是评估年轻患者采用预塑形角稳定钢板切开复位内固定治疗肱骨远端骨折的功能结果,并调查患者能否恢复伤前工作以及在未工作期间的经济状况。

材料与方法

回顾性评估48例年龄在18至55岁之间、有工作且患有AO/OTA C型肱骨远端骨折患者的数据。采用梅奥肘关节功能评分(MEPS)来确定功能结果。通过术后X线片评估骨折愈合率、退变改变、畸形愈合和异位骨化情况。作者编制了经济结果表格,询问患者治疗结束后能否恢复伤前工作以及治疗期间和治疗后的经济状况。

结果

平均屈伸弧为114°±12°(范围85°-135°),平均MEPS评分为85±11(范围65-100)。平均重返工作时间为6.5±2.4个月(3-12个月)。AO C2型和C3型骨折以及异位骨化对功能结果有负面影响,也对患者恢复伤前工作产生不利影响。38例(79%)患者恢复了伤前工作,其中29例(76%)在骨折前的相同岗位重新工作。38例患者中有9例(24%)不得不更换岗位。48例患者中,10例(21%)无法回到原工作岗位,其中7例从事轻体力工作,3例未再工作。

结论

虽然肱骨远端关节内骨折手术治疗的功能结果良好,但在治疗结束时,尤其是从事重体力工作的患者可能难以恢复原工作。

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