两种评分系统对髋臼后壁骨折的预后评价

Prognostic evaluation of posterior wall fractures of the acetabulum by two scoring systems

[目的]采用2种评分系统对髋臼后壁骨折术后Ⅰ期疗效的信息进行比较。[方法]观察32位髋臼后壁骨折术后随访至少1年以上患者。采用the short form（SF）-36量表8项独立指标评估整体功能疗效及改良Merle d’Aubigné评分法评估临床疗效。SF-36得分与以往文献提供的正常参考值进行比较,并分析改良Merle d’Aubigne得分与SF-36各纬度得分的相关性。[结果]平均Merle d’Aubign得分是16.28（13～18,标准差：1.3）,显示临床疗效优良。SF-36各纬度值比参考值都明显下降,有显著统计学意义（P〈0.01）。改良Merle d’Aubigné评分与躯体角色（role physical,RP）、躯体功能（physical functioning,PF）、情感角色（role emotional,RE）得分之间为正相关,Spearman相关系数分别是0.661、0.421、0.385,与其他纬度之间无相关性。[结论]改良Merle d’Aubigné评分法对评估髋臼骨折患者术后髋关节功能有临床意义,但在评估整体功能疗效上受限制。SF-36评分可全面测评患者术后各方面功能。对髋臼骨折病人围手术期要积极采取心理保健治疗。

[ Objective]To evaluate the outcome inforation provided by two scoring systems after operative treatment of elementary posterior wall fractures of the acetabulum. [ Method ] Thirty,two patients with elementary posterior wall fracture of the acetabulum were included in the study. Functional outcomes were assessed with use of the eight health dimensions of the short form （SF） -36, and clinical outcomes were evaluated with use of the modified Merle d＇Aubigne score. The SF- 36 scores were compared with previously reported normal values and the correlation was analyzed between the modified Merle d＇ Aubign＇ score and score of each SF- 36 health dimension. [ Result]The mean modified Merle d＇Aubign6 score was 16.28 （range 13 -18,SD 1. 3 ）, indicating overall good -to -excellent clinical results. However, all SF -36 health dimensions were significatly lower than the expected forms ,with a significant statistical difference（ P 〈0.01 ）. There was a positive correlation between the modified Merle d＇ Aubigne score and physical functioning（PF） ,role physical（RP） and role emotional（RE）. The Spearman rank correlation coefficient was O. 661,0.421 and 0. 385, respectively. There was no correlation with other SF - 36 health dimensions. [ Conclusion ] Although the modified Merle d＇Aubigne score is valuable for evaluating isolated hip function in patients with acetabular fracture,its shortcoming is use as a method for evaluating total functional outcome. SF - 36 can appraise all aspects of postoperative function. Psychological health care should be carried out at perioperation.