肘关节术后6种不同功能评分标准的比较

Comparion of 6 functional tests for postoperative elbow function evaluation

目的对目前临床上应用较多的6种肘关节评分标准进行比较，为临床肘关节术后评分标准的选择提供理论依据。方法选择北京大学人民医院创伤骨科2004年1月—2006年8月收治的31例肱骨髁间、髁上骨折病例，采用6种不同的评分标准分别对患者手术后肘关节功能恢复情况进行评价，借助统计学方法并结合临床分析每种评分标准的优缺点。结果各评分系统总分之间的相关性不等，各评分内部各组成部分之间相关性显著，其中年龄与功能负相关、功能与疼痛负相关，各评分均与年龄因素之间存在着较强的负相关。结论Mayo评分、HSS2评分侧重患者主观感受，改良An和Morrey评分和HSS评分侧重医生客观检查，改良Broberg和Money评分、DeBoerYA评分主客观相对均衡。综合分析本文推荐HSS评分作为医生对患肘功能评价的首选方法，HSS2评分作为患者对患肘进行自评的首选方法。

Objective Several elbow function scores are used in research, but there is no universally adopted standard. In this study 6 elbow out.me scales were compared to provide basis for seleetion of postoperative elbow functional evaluation criteria. Methods Thirty-one patients who underwent elbow surgery for humeral condyle fractures or supracondyle fractures from January 2004 to August 2006 were involved in the study. Postoperatively their elbow function was evaluated using 6 widely applied elbow scores, clinical examinations, and radiographic examinations. Pearson correlations were calculated between the total scores of the 6 instruments, between the components of the scales, and with age. Regression equations were calculated between scales. R^3111ts There was no obvious relationship between the total scores. However the relationship between components of different score systems was tight. There was a negative correlation between age and function and between function and pain. The age factor had a high negative correlation score with every score system. Conclusion Mayo score, HSS2 score particularly emphasize on patientsSubjective assessment. Modified An and Morley score and HSS score emphasize more on objective examination. Modified Broberg and Money score and de Boer YA score were relatively balanced for both subjective and objective assessment. We recommend HSS score as the first choice for clinician based outcomes and recommend HSS2 score to evaluate patient reported outcomes.