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英国一家三级护理医院肩关节脱位治疗后的功能结果与预后指标评估

An Assessment of Functional Outcomes and Prognostic Measures Following the Management of Shoulder Dislocations at a Tertiary Care Hospital in the United Kingdom.

作者信息

Nath Upamanyu, Mohindra Roshan, Bin Sahl Abdullah, Ibrahim Mohammad, Pillai Anand

机构信息

Trauma and Orthopaedics, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, GBR.

Trauma and Orthopaedics, Royal College of Surgeons in Ireland, Dublin, IRL.

出版信息

Cureus. 2024 Nov 1;16(11):e72817. doi: 10.7759/cureus.72817. eCollection 2024 Nov.

Abstract

Background and objective Shoulder dislocations account for around half of all major joint dislocations in the UK and pose a significant healthcare burden. Management decisions post-reduction procedures involve a range of options, including conservative measures, surgery, and physiotherapy. Patient-reported outcome measures (PROMs), such as the Oxford Shoulder Instability Score (OSIS) and Simple Shoulder Test (SST), have emerged as crucial tools for evaluating treatment outcomes, reflecting a shift towards patient-centred care. This study aimed to evaluate trends related to prognostic factors versus PROMs following the management of shoulder dislocations at a tertiary care centre. Methods An observational, retrospective cohort study was conducted at Wythenshawe Hospital, Manchester, involving 70 patients with shoulder instability. Patient demographics, management strategies, and outcomes were evaluated using PROMs, focusing on functional disability assessed by OSIS and SST. Prognostic factors, including age, recurrence, and physiotherapy, were examined to understand their impact on treatment efficacy. Results The study included a diverse patient demographic, with both OSIS and SST scores showing a downward trend with increasing age. Physiotherapy correlated with improved SST scores, emphasising its role in rehabilitation. Limited physiotherapy availability and variations in patient-reported data posed challenges in assessing the cohort-wide impact of treatment. Conclusions The observed correlation between functional outcomes and patient perceptions underscores the intricate relationship between physical function and subjective experiences, contributing to the nuanced understanding of shoulder dislocation management.

摘要

背景与目的 在英国,肩关节脱位约占所有主要关节脱位的一半,造成了重大的医疗负担。复位手术后的管理决策涉及一系列选择,包括保守措施、手术和物理治疗。患者报告的结局指标(PROMs),如牛津肩关节不稳定评分(OSIS)和简易肩关节测试(SST),已成为评估治疗效果的关键工具,反映了向以患者为中心的医疗模式的转变。本研究旨在评估在一家三级医疗中心对肩关节脱位进行管理后,与预后因素和患者报告的结局指标相关的趋势。方法 在曼彻斯特的怀森肖医院进行了一项观察性回顾性队列研究,纳入70例肩关节不稳定患者。使用患者报告的结局指标评估患者的人口统计学特征、管理策略和结局,重点关注通过OSIS和SST评估的功能障碍。研究预后因素,包括年龄、复发情况和物理治疗,以了解它们对治疗效果的影响。结果 该研究纳入了不同的患者群体,OSIS和SST评分均显示随年龄增长呈下降趋势。物理治疗与SST评分的改善相关,强调了其在康复中的作用。物理治疗资源有限以及患者报告数据的差异给评估治疗对整个队列的影响带来了挑战。结论 观察到的功能结局与患者认知之间的相关性强调了身体功能与主观体验之间的复杂关系,有助于对肩关节脱位管理的细致理解。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/41b7/11608419/51bdd0956e68/cureus-0016-00000072817-i01.jpg

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