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OTA/AO61-B 和 61-C 骨盆环损伤术后步态、髋关节力量和患者报告结果分析。

Analysis of Postoperative Gait, Hip Strength, and Patient-Reported Outcomes After OTA/AO 61-B and 61-C Pelvic Ring Injuries.

机构信息

Department of Orthopedics, University of Colorado, Aurora, CO.

Department of Orthopedics, Denver Health Medical Center, Denver, CO.

出版信息

J Orthop Trauma. 2022 Sep 1;36(9):432-438. doi: 10.1097/BOT.0000000000002359.

Abstract

OBJECTIVES

To examine clinical gait parameters, hip muscle strength, pelvic functional outcomes, and psychological outcomes after surgical fixation of OTA/AO 61-B and 61-C pelvic ring injuries.

DESIGN

Retrospective review identified 10 OTA/AO 61-B patients and 9 OTA/AO 61-C patients for recruitment who were between 1 and 5 years after pelvic fixation. Gait and strength assessments, and patient-reported outcome scores were performed/collected and analyzed.

SETTING

Outpatient clinical motion performance laboratory.

PATIENTS/PARTICIPANTS: Patients with OTA/AO 61-B and OTA/AO 61-C fractures who were between 1 and 5 years after pelvic fixation.

MAIN OUTCOME MEASUREMENTS

Hip strength, kinetics, and spatial-temporal outcomes; Majeed Pelvic Outcome Score; Short Form 36; Hamilton Anxiety/Depression Rating Scales.

RESULTS

There were no differences in age, body mass index, or time since definitive fixation between OTA/AO 61-B and 61-C groups. The OTA/AO 61-C group had higher median injury severity scores, longer length of stay, and greater postoperative pelvic fracture displacement. There was no difference in bilateral hip strength, bilateral peak hip moments, peak hip power, and walking speed between groups. Patients with OTA/AO 61-C fractures had lower scores on Short Form 36 General Health and Majeed Work, with a trend toward a lower Total Majeed score. There were no differences in self-reported total anxiety and depression symptoms.

CONCLUSIONS

This study did not identify any gait, strength, or psychological differences between OTA/AO 61-B and 61-C injuries at 1-5 years of follow-up. However, increased injury severity in OTA/AO 61-C patients may have residual consequences on perceived general health and ability to work. This pilot study establishes a template for future research into functional recovery of patients with severe pelvic ring trauma.

LEVEL OF EVIDENCE

Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.

摘要

目的

研究 OTA/AO 61-B 和 61-C 型骨盆环损伤手术固定后临床步态参数、髋关节肌力、骨盆功能结局和心理结局。

设计

回顾性研究纳入了 10 例 OTA/AO 61-B 患者和 9 例 OTA/AO 61-C 患者,均为骨盆固定后 1-5 年。进行步态和力量评估,并收集和分析患者报告的结局评分。

地点

门诊临床运动表现实验室。

患者/参与者:OTA/AO 61-B 和 OTA/AO 61-C 骨折患者,骨盆固定后 1-5 年。

主要测量指标

髋关节力量、动力学和时空结果;Majeed 骨盆结局评分;SF-36 量表;汉密尔顿焦虑/抑郁量表评分。

结果

OTA/AO 61-B 和 61-C 组之间在年龄、体重指数或确定性固定后时间方面无差异。OTA/AO 61-C 组损伤严重程度评分较高,住院时间较长,术后骨盆骨折移位较大。两组间双侧髋关节力量、双侧髋关节峰值力矩、髋关节峰值功率和行走速度无差异。OTA/AO 61-C 骨折患者 SF-36 一般健康和 Majeed 工作评分较低,Majeed 总评分有降低趋势。自述总焦虑和抑郁症状无差异。

结论

本研究在 1-5 年随访时未发现 OTA/AO 61-B 和 61-C 损伤之间存在步态、力量或心理差异。然而,OTA/AO 61-C 患者损伤严重程度增加可能对一般健康和工作能力的感知有残留影响。本初步研究为严重骨盆环创伤患者功能恢复的进一步研究奠定了基础。

证据水平

预后 III 级。请参阅作者说明以获取完整的证据水平描述。

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