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影响孤立性 Lisfranc 损伤手术干预后 PROMIS 评分和患者报告结局的因素:至少 2 年随访。

Factors Influencing PROMIS Scores and Patient Reported Outcomes Following Surgical Intervention of Isolated Lisfranc Injury: Minimum 2 Year Follow-up.

机构信息

Department of Orthopaedic Surgery, University of Alabama, Birmingham, AL.

Department of Orthopaedic Surgery, University of Alabama, Birmingham, AL.

出版信息

J Foot Ankle Surg. 2024 May-Jun;63(3):359-365. doi: 10.1053/j.jfas.2024.01.005. Epub 2024 Jan 20.

DOI:10.1053/j.jfas.2024.01.005
PMID:38246337
Abstract

Lisfranc injuries are rare but significant foot injuries, as they often result from polytrauma patients, and are often misdiagnosed, which further complicate their evaluation and contribute to their propensity towards disability. It is recommended that, on diagnosis, Lisfranc injuries be treated as soon as possible to decrease the risk of future chronic pain, disability, or osteoarthritis. Our study evaluated patients who completed the patient reported outcome measurement information systems (PROMIS) along with the foot function index (FFI) following operative fixation for Lisfranc injury. Fifty-one patients between 2010 and 2020 met inclusion criteria and were selected for this study, with completion. Utilizing the electronic medical record (EMR), patient charts were reviewed to obtain basic patient demographic information and comorbidities. Operative reports were reviewed to determine which procedure was performed for definitive fixation. Primary arthrodesis was associated with a significant decrease in complication rates (p = .025) when compared to ORIF. Females, arthrodesis, and procedures using a home run (HR) screw were independent risk factors for significantly higher reports of PROMIS pain interference. Arthrodesis also was associated with lower PROMIS pain interference scores. Arthrodesis and males exhibited higher scores in all FFI categories. Our results provide evidence that patient reported outcomes following Lisfranc surgery reported via PROMIS, FFI and VAS scores are independently influenced by patient demographics, comorbidities, and surgical variables. Analysis of potential associations between these patient characteristics and PROMIS and FFI scores provides evidence for physicians to manage patient expectations prior to operative treatment of a nonpolytraumatic Lisfranc injury.

摘要

跖跗关节损伤较为罕见但后果严重,常发生于多发创伤患者,且易误诊,这进一步增加了其评估难度,导致患者残疾的可能性增加。建议一旦确诊跖跗关节损伤,应尽快进行治疗,以降低未来发生慢性疼痛、残疾或骨关节炎的风险。本研究评估了接受手术固定治疗的跖跗关节损伤患者完成患者报告结局测量信息系统(PROMIS)和足功能指数(FFI)的情况。2010 年至 2020 年间,51 名符合纳入标准并完成研究的患者入选本研究。利用电子病历(EMR),回顾患者病历以获取基本患者人口统计学信息和合并症。回顾手术记录以确定用于确定性固定的手术方式。与切开复位内固定术(ORIF)相比,切开复位内固定术与并发症发生率显著降低相关(p =.025)。女性、融合术和使用顺行(HR)螺钉的手术是 PROMIS 疼痛干扰报告显著更高的独立危险因素。融合术也与 PROMIS 疼痛干扰评分较低相关。融合术和男性在所有 FFI 类别中得分均较高。我们的研究结果表明,通过 PROMIS、FFI 和 VAS 评分报告的跖跗关节手术后患者报告结局受到患者人口统计学、合并症和手术变量的独立影响。对这些患者特征与 PROMIS 和 FFI 评分之间的潜在关联进行分析,为医生在对非多发创伤性跖跗关节损伤进行手术治疗前管理患者的预期提供了依据。

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