儿童肢体骨折与视力损害的关系：病例对照研究。

The relationship between extremity fractures and visual impairment in childhood: A case-control study.

机构信息

Department of Orthopaedic and Traumatology, Ordu University Training and Research Hospital, Ordu-Turkey.

Department of Ophthalmology, Ordu University Training and Research Hospital, Ordu-Turkey.

出版信息

Ulus Travma Acil Cerrahi Derg. 2022 May;28(5):662-667. doi: 10.14744/tjtes.2022.90235.

DOI:10.14744/tjtes.2022.90235

PMID:35485477

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10442978/

Abstract

BACKGROUND

Fractures are common extremity injuries in pediatric orthopedic practice. The aim of this study is to determine the relationship between pediatric extremity fractures and visual impairments.

METHODS

Thirty pediatric patients who were admitted to the emergency and orthopedics and traumatology clinic due to an extremity fracture after a fall were included in the study. Following fracture treatment, the patients were evaluated in terms of ocu-lar findings before discharge from the hospital. Thirty age- and sex-matched healthy children who presented to the ophthalmology department for routine care were also recruited as the control group. All participants underwent a comprehensive ophthalmologic examination, including cycloplegic refraction, visual acuity levels, and near stereoacuity measurement.

RESULTS

The number of male participants was higher in both groups. There was no significant difference between the groups in terms of age and gender distribution. The most common upper extremity fractures were observed to be distal radius (52%) and distal humerus fractures (28%). The number of patients who had a refractive error that required spectacles was significantly higher in the fracture group (p=0.039). When the visual acuity levels of the better eye were evaluated, the mean visual acuity was significantly lower in the fracture group (p=0.016). The mean stereoacuity was also significantly lower in the study group (<0.001). In the binary logistic regression analysis model, low stereopsis levels were associated with the risk of pediatric extremity fractures (95% CI: 1.056-1.385; p=0.006).

CONCLUSION

Our study showed that low-energy pediatric extremity fractures are more common in children with visual im-pairments that require treatment, and low stereopsis is a risk factor for fractures. Consequently, regular eye examinations and early treatment of visual impairments in children may help to prevent fall-related injuries.

摘要

背景

骨折是小儿矫形骨科常见的四肢损伤。本研究旨在确定小儿四肢骨折与视力损害之间的关系。

方法

30 名因跌倒导致四肢骨折而入住急诊和矫形与创伤科的小儿患者纳入本研究。在骨折治疗后，在患儿出院前评估其眼部检查结果。同时还招募了 30 名因常规眼科护理就诊的年龄和性别匹配的健康儿童作为对照组。所有参与者均接受了全面的眼科检查，包括睫状肌麻痹验光、视力水平和近立体视测量。

结果

两组中男性参与者的人数均较高。两组在年龄和性别分布方面无显著差异。最常见的上肢骨折是桡骨远端（52%）和肱骨远端骨折（28%）。在骨折组中，需要戴眼镜矫正屈光不正的患者人数明显更高（p=0.039）。当评估优势眼的视力水平时，骨折组的平均视力明显较低（p=0.016）。研究组的平均立体视也明显较低（<0.001）。在二元逻辑回归分析模型中，低立体视水平与小儿四肢骨折的风险相关（95%CI：1.056-1.385；p=0.006）。