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桡骨远端骨折手术治疗后的中枢敏化量表评分

Central sensitization inventory score after surgical treatment for distal radius fractures.

作者信息

Naito Kiyohito, Imazu Norizumi, Ishi Shoichiro, Yamamoto Yasuhiro, Suzuki Takamaru, Kawamura Kenjiro, Kawakita So, Itoh Tatsuki, Ishijima Muneaki

机构信息

Department of Medicine for Orthopedics and Motor Organ, Juntendo University Graduate School of Medicine, Tokyo, Japan.

Department of Orthopedics, Juntendo University Faculty of Medicine, Tokyo, Japan.

出版信息

Eur J Orthop Surg Traumatol. 2025 May 12;35(1):187. doi: 10.1007/s00590-025-04310-8.

Abstract

PURPOSE

Volar locking plate (VLP) fixation for distal radius fractures has relatively stable clinical outcomes. However, surgeons who assess postoperative outcomes as good may have difficulty fully understanding the perspectives of patients who express dissatisfaction. Central sensitization inventory (CSI) score is now thought to assess psychogenic pain. Therefore, clinical evaluation related to CSI score following volar locking plate fixation for distal radius fractures in this study.

METHODS

Twenty-nine distal radius fracture patients (12 males and 17 females; mean age: 55.2 ± 15.9 years) treated with VLP were included. At final follow up before removal of volar locking plate, wrist joint range of motion (flexion, extension, pronation, and supination), grip strength (% of the healthy side), numerical rating scale (NRS), quick disabilities of the arm, shoulder, and hand (Q-DASH) score, and CSI score were investigated. In addition, the association between each evaluation item and Q-DASH and CSI scores was analyzed using univariate analysis.

RESULTS

Wrist range of motion and grip strength were not associated with CSI score (flexion: P = 0.651, r = - 0.089; extension: P = 0.689, r = 0.079; pronation: P = 0.241, r = 0.229; supination: P = 0.864, r = 0.034; grip strength healthy side ratio: P = 0.582, r = - 0.109). On the other hand, NRS (P = 0.038, r = 0.393) and Q-DASH scores (P = 0.012, r = 0.469) were significantly associated with CSI scores.

CONCLUSIONS

This study suggested that after volar locking plate fixation (before plate removal), patient-reported outcomes (Q-DASH score and CSI score) were not associated with clinician-reported outcomes and impairment measure.

摘要

目的

桡骨远端骨折采用掌侧锁定钢板(VLP)固定具有相对稳定的临床疗效。然而,评估术后结果为良好的外科医生可能难以充分理解表示不满的患者的观点。中枢敏化量表(CSI)评分目前被认为可评估心理性疼痛。因此,本研究对桡骨远端骨折采用掌侧锁定钢板固定后与CSI评分相关的临床评估进行研究。

方法

纳入29例采用VLP治疗的桡骨远端骨折患者(男12例,女17例;平均年龄:55.2±15.9岁)。在拆除掌侧锁定钢板前的末次随访时,调查腕关节活动范围(屈曲、伸展、旋前和旋后)、握力(健侧的百分比)、数字评定量表(NRS)、手臂、肩部和手部快速残疾量表(Q-DASH)评分以及CSI评分。此外,使用单因素分析分析每个评估项目与Q-DASH和CSI评分之间的关联。

结果

腕关节活动范围和握力与CSI评分无关(屈曲:P = 0.651,r = -0.089;伸展:P = 0.689,r = 0.079;旋前:P = 0.241,r = 0.229;旋后:P = 0.864,r = 0.034;握力健侧比值:P = 0.582,r = -0.109)。另一方面,NRS(P = 0.038,r = 0.393)和Q-DASH评分(P = 0.012,r = 0.469)与CSI评分显著相关。

结论

本研究表明,在掌侧锁定钢板固定后(钢板拆除前),患者报告的结果(Q-DASH评分和CSI评分)与临床医生报告的结果及损伤测量指标无关。

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