工伤赔偿患者完全性近端腘绳肌撕脱伤的开放修复术
Open Repair of Complete Proximal Hamstring Avulsions in Workers' Compensation Patients.
作者信息
Johnson Emma E, Brutico Joseph M, Rangavajjula Lasya, Xia Yuwei, Paul Ryan W, Otlans Peters, Arner Justin W, Hammoud Sommer, Bradley James P, Cohen Steven B
机构信息
Rothman Orthopaedic Institute at Thomas Jefferson University, Philadelphia, Pennsylvania, USA.
Department of Orthopaedic Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
出版信息
Orthop J Sports Med. 2022 Sep 1;10(9):23259671221119774. doi: 10.1177/23259671221119774. eCollection 2022 Sep.
BACKGROUND
Several studies have reported excellent results after surgical repair of proximal hamstring avulsions. However, the effect on these patients of receiving workers' compensation has not yet been explored.
HYPOTHESIS
Workers' compensation patients undergoing proximal hamstring repair of complete tears will have similar outcomes when compared with a matched control group of non-workers' compensation patients.
STUDY DESIGN
Cohort study; Level of evidence, 3.
METHODS
Workers' compensation patients who underwent complete proximal hamstring avulsion open repair between 2010 and 2019 were identified (WC group). A control group was matched by age (±3 years), sex, and body mass index (BMI; ±3). Demographics and patient-reported outcome measures were compared, including standard and custom Marx activity rating scale (MARS), standard and custom lower extremity functional scale (LEFS), and visual analog scale (VAS) for pain. Rate and time to return to work were recorded.
RESULTS
The WC group was composed of 20 patients (8 men, 12 women) with a mean age of 52.3 years and BMI of 32.4. The 20 matched controls (8 men, 12 women) who underwent repair had a mean age of 50.6 years and a mean BMI of 31.2. There was no difference between the groups regarding age ( = .924), sex ( > .999), or BMI ( = .330). The WC group reported similar mean MARS (3.3 vs 5.4; = .174), custom MARS (87.5 vs 97.0; = .215), and VAS pain (3.3 vs 3.8; = .698) scores compared with controls. However, the WC group had significantly lower standard LEFS (69.1 vs 94.1; < .001) and custom LEFS (62.3 vs 87.9; < .001) scores, returned to work at a lower rate (70.0% vs 94.1%; = .039), and required more time to return to work after repair (4.3 vs 3.5 months; = .029) compared with controls.
CONCLUSION
Workers' compensation patients who underwent open proximal hamstring repair for complete avulsions experienced inferior patient-reported outcomes, required more time to return to work, and returned to work at a lower rate than a matched control group.
背景
多项研究报告了腘绳肌近端撕脱伤手术修复后的良好效果。然而，尚未探讨工伤赔偿对这些患者的影响。
假设
与匹配的非工伤赔偿对照组相比，接受完全撕裂的腘绳肌近端修复的工伤赔偿患者将有相似的结果。
研究设计
队列研究；证据等级，3级。
方法
确定2010年至2019年间接受完全性腘绳肌近端撕脱伤开放修复的工伤赔偿患者（工伤赔偿组）。对照组按年龄（±3岁）、性别和体重指数（BMI；±3）进行匹配。比较人口统计学和患者报告的结局指标，包括标准和定制的马克思活动评分量表（MARS）、标准和定制的下肢功能量表（LEFS）以及疼痛视觉模拟量表（VAS）。记录重返工作岗位的比率和时间。
结果
工伤赔偿组由20例患者组成（8例男性，12例女性），平均年龄52.3岁，BMI为32.4。20例接受修复的匹配对照组（8例男性，12例女性）平均年龄50.6岁，平均BMI为31.2。两组在年龄（P = 0.924）、性别（P>0.999）或BMI（P = 0.330）方面无差异。与对照组相比，工伤赔偿组报告的平均MARS（3.3对5.4；P = 0.174）、定制MARS（87.5对97.0；P = 0.215）和VAS疼痛评分（3.3对3.8；P = 0.698）相似。然而，工伤赔偿组的标准LEFS（69.1对94.1；P<0.001）和定制LEFS（62.3对87.9；P<0.001）评分显著较低，重返工作岗位的比率较低（70.0%对94.1%；P = 0.039），修复后重返工作岗位所需时间更长（4.3对3.5个月；P = 0.029）。
结论
接受开放性腘绳肌近端完全撕脱伤修复的工伤赔偿患者，其患者报告的结局较差，重返工作岗位所需时间更长，且重返工作岗位的比率低于匹配的对照组。
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