Tijare Chinmay
Orthopaedics, University of Leicester, Leicester, GBR.
Cureus. 2024 Feb 1;16(2):e53361. doi: 10.7759/cureus.53361. eCollection 2024 Feb.
Background The medium-term outcomes of patients (six to 14 months post-injury) with non-specific wrist injuries managed as suspected scaphoid fractures are not clear from the current literature. These patients' wrists are immobilized in casts or splints, and some receive physiotherapy. They receive serial imaging and follow-up appointments as needed. Aims This study aims to describe the medium-term outcomes of patients with non-specific wrist injuries managed as suspected scaphoid fractures. Methods This is a single-centre retrospective cohort study. Patients with suspected scaphoid fractures were identified from a consecutive database and were included. Patients diagnosed with a definitive scaphoid fracture at any point in time were excluded. Patients with any pre-existing wrist pathology were also excluded. In total 113 patients were posted the Patient-Rated-Wrist-Evaluation (PRWE) questionnaire at six to 14 months post-injury with a self-addressed return envelope. Demographic and PRWE data were collated and described. Results Twenty-two patients (19% of total patients) returned a completed questionnaire. The median PRWE score was 32 out of 100 indicating mild pain and disability. 45.5% of patients were in this category. A minority of patients (9%) continued to suffer severe or very severe pain and disability. Patients with PRWE scores <40, representing pain and disability that is mild or less, reported very low difficulty completing work and recreational activities. Patients tended not to have pain at rest and experienced the most difficulty lifting heavy objects. Conclusion Most patients with non-specific wrist injuries managed as suspected scaphoid fractures experience some pain and disability in the medium term. For most this is minimal or mild, however some patients experience significant pain and disability. This study adds to existing evidence that this is the case. The reasons why these patients suffer are unclear. This study highlights the need to refine clinical practice to improve the outcomes of these patients.
目前的文献中尚不清楚疑似舟骨骨折的非特异性腕部损伤患者（受伤后6至14个月）的中期结局。这些患者的手腕用石膏或夹板固定，一些患者接受物理治疗。他们根据需要接受系列影像学检查和随访预约。目的：本研究旨在描述疑似舟骨骨折的非特异性腕部损伤患者的中期结局。方法：这是一项单中心回顾性队列研究。从连续数据库中识别出疑似舟骨骨折的患者并纳入研究。排除在任何时间点被诊断为明确舟骨骨折的患者。也排除任何既往存在腕部病变的患者。总共113例患者在受伤后6至14个月收到了患者自评腕关节评估（PRWE）问卷，并附有回邮信封。整理并描述人口统计学和PRWE数据。结果：22例患者（占总患者的19%）返回了完整问卷。PRWE评分中位数为100分中的32分，表明疼痛和残疾程度较轻。45.5%的患者属于这一类别。少数患者（9%）继续遭受严重或非常严重的疼痛和残疾。PRWE评分<40分的患者，代表轻度或更低程度的疼痛和残疾，报告完成工作和娱乐活动的困难非常低。患者往往休息时无疼痛，举起重物时最困难。结论：大多数疑似舟骨骨折的非特异性腕部损伤患者在中期会经历一些疼痛和残疾。对大多数人来说，这是轻微的，然而一些患者经历了显著的疼痛和残疾。本研究补充了现有证据表明情况确实如此。这些患者受苦的原因尚不清楚。本研究强调需要改进临床实践以改善这些患者的结局。
