Patient-reported outcome following an acetabular fracture: an observational study of 385 patients from the Swedish Fracture Register.

IF 2.5 2区 医学 Q1 ORTHOPEDICS
Madelene Albrektsson, Michael Möller, Mikael Sundfeldt, David Wennergren, Olof Wolf, Carl Bergdahl
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Abstract

Background and purpose:  The primary aim of this study was to assess the patient's self-reported change in health 1 year after sustaining an acetabular fracture. The secondary objective was to examine differences in patient-reported outcomes (PROMs) based on sex, age groups, injury mechanisms, type of fracture, and treatment.

Methods:  Data was collected from the Swedish Fracture Register (SFR) for patients with acetabular fractures sustained between 2014 and 2021. Patients with additional fractures at the time of injury or during the following 18 months, periprosthetic fractures, or pediatric fractures were excluded. The PROM used was the Short Musculoskeletal Function Assessment (SMFA) wherein the subindices of bother, dysfunction, and mobility were analyzed with a higher score indicating worse outcome. The differences in SMFA and in subindices between the score 1 year after fracture and preinjury (recall) were analyzed.

Results:  Of the 385 included patients with complete PROMs, there was no significant difference in changes in SMFA score between the sexes. Surgically treated patients had significantly higher scores 1 year post-injury compared with non-surgically treated patients with bother index 18.3 (95% confidence [CI] 14.0-22.6) vs 7.2 (CI 4.7-9.8), dysfunction index 15.8 (CI 12.7-18.9) vs 7.0 (CI 5.0-9.0), and mobility index 21.6 (CI 17.9-25.2) vs 9.2 (CI 6.9-11.5).

Conclusion:  Most patients sustaining an acetabular fracture experience a decline in their functional abilities 1 year after the injury compared with before the injury. Younger patients with high-energy injuries and complex fracture types, which typically require surgical intervention, experience the most unfavorable outcomes. The large group of non-surgically treated patients reported minimal functional changes, likely attributable to selection bias.

髋臼骨折后患者报告的结果:对瑞典骨折登记处 385 名患者的观察研究。
背景和目的:本研究的主要目的是评估髋臼骨折 1 年后患者自我报告的健康状况变化。次要目的是根据性别、年龄组、受伤机制、骨折类型和治疗方法,研究患者报告结果(PROMs)的差异: 瑞典骨折登记处(SFR)收集了2014年至2021年间髋臼骨折患者的数据。受伤时或之后18个月内有其他骨折、假体周围骨折或小儿骨折的患者不包括在内。使用的PROM是短期肌肉骨骼功能评估(SMFA),对困扰、功能障碍和活动能力等子指标进行分析,得分越高,预后越差。分析了骨折 1 年后的评分与受伤前(回忆)的评分在 SMFA 和各分指数上的差异: 结果:在385名具有完整PROM的患者中,男女患者的SMFA评分变化无显著差异。与非手术治疗患者相比,手术治疗患者在伤后1年的评分明显更高,困扰指数为18.3(95% 置信度[CI] 14.0-22.6) vs 7.2 (CI 4.7-9.8),功能障碍指数为15.8 (CI 12.7-18.9) vs 7.0 (CI 5.0-9.0),活动指数为21.6 (CI 17.9-25.2) vs 9.2 (CI 6.9-11.5): 结论:与受伤前相比,大多数髋臼骨折患者在受伤 1 年后的功能会有所下降。高能量损伤和复杂骨折类型的年轻患者通常需要手术治疗,他们的预后最差。大部分未接受手术治疗的患者的功能变化极小,这可能是由于选择偏差造成的。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Acta Orthopaedica
Acta Orthopaedica 医学-整形外科
CiteScore
6.40
自引率
8.10%
发文量
105
审稿时长
4-8 weeks
期刊介绍: Acta Orthopaedica (previously Acta Orthopaedica Scandinavica) presents original articles of basic research interest, as well as clinical studies in the field of orthopedics and related sub disciplines. Ever since the journal was founded in 1930, by a group of Scandinavian orthopedic surgeons, the journal has been published for an international audience. Acta Orthopaedica is owned by the Nordic Orthopaedic Federation and is the official publication of this federation.
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