桡骨远端不稳定骨折内固定术后多种主客观评分系统与患者主观满意度的相关性研究

The correlation study between the subjective satisfaction of patients and the functional scoring systems of the wrist after unstable distal radial fractures

目的探讨桡骨远端不稳定骨折经切开复位锁定钢板内固定术后患者腕关节功能主观满意度评价与临床G-W评分及DASH评分等主、客观评分系统的相关性。方法回顾性分析2013年5月至2015年8月桡骨远端骨折切开复位钢板内固定患者32例,随访测量各阶段患者腕关节屈伸角度、握力、疼痛、旋转等,收集整理术后3个月、6个月、12个月及随访终点G-W评分、DASH评分及患者功能恢复主观满意度评价,SPSS 16.0对资料统计均数、标准差,行正态性检验,方差分析,并就主观满意度与其他主、客观评价系统进行相关性分析。结果随访结果术后3个月、6个月、12个月及终点患者功能恢复主观满意度(百分制)为59.62±9.15、84.9±10.19、94.5±6.76、95±5.14,术后3个月、6个月、12个月及终点客观G-W评分为2.30±1.96、1.39±1.63、1.07±1.25、0.89±1.03,术后3个月、6个月、12个月及终点DASH评分7.31±1.66、4.49±1.85、2.66±1.28、2.55±1.09,各项指标随时间点不断改善,各组间统计学均有显著性差异(P<0.01)。相关性分析研究显示各随访时间点患者主观满意度与客观G-W评分中等度相关,相关系数r=0.41~0.52,有显著统计学意义(P<0.05)。随访各时间点患者主观满意度与DASH评分相关,r=0.20~0.40,除术后6个月时间点外,其余均无显著统计学意义(P>0.05)。结论桡骨远端不稳定骨折经切开复位锁定钢板内固定术后,临床效果满意,各临床评分系统有效,但各有侧重,患者主观满意度与临床客观G-W评分相关性具有统计学显著性意义,较适用于国内临床。主观满意度与主客观综合DASH评分弱相关,临床应用需进一步细化分析原因。

Objective To study the relationship between the wrist recovery function satisfaction and the G-W scoring system,DASH system after open reduction and internal fixation operation in distal radius fractures. Methods A total of 32 patients after open reduction and internal fixation operation in distal radius fractures in our hospital from May 2013 to August 2015 were selected in this study. The data of the movement angle of the wrist including flexion,extension,rotation,pain and grip,the wrist recovery function satisfaction were collected. The G-W score,DASH score and subjective satisfaction of patients at 3 months,6 months,12 months and the following-up end point after operation were collected. The correlation between them were compared with SPSS 16. 0. Results The wrist recovery function satisfaction of the patients were 59. 62 ± 9. 15,84. 9 ± 10. 19,94. 5 ± 6. 76,95 ± 5. 14,respectively. G-W scoring at 3 months,6 months,12 months,endpoint after operation were 2. 30 ± 1. 96,1. 39 ± 1. 63,1. 07 ± 1. 25,0. 89 ± 1. 03,respectively; The DASH score at 3 months,6 months,12 months,endpoint after operation were 7. 31 ± 1. 66,4. 49 ± 1. 85,2. 66 ± 1. 28,2. 55 ± 1. 09,respectively. The wrist recovery function subjective satisfaction of the patients had moderate correlation with the G-W score,r = 0. 41-0. 52,P〈0.05. There was no significant difference between the wrist recovery function satisfaction of the patients and the DASH score except the data of 6 month after operation. Conclusion There is significant difference between the wrist recovery function subjective satisfaction of the patients and the G-W score of the patients after open reduction and internal fixation operation in distal radius fractures,and G-W scoring system maybe suitable in clinical application for Chinese. While there is mild correlation between subjective satisfaction and DASH system scoring system,the clinical application should be discussed.