COVID-19封锁对印度三级医疗中心加压钢板治疗双骨前臂骨折的临床和放射学结果的影响:一项回顾性研究。

IF 1.4 Q3 EMERGENCY MEDICINE
Dibya Ranjan Sahoo, John A Santoshi, Prateek Behera, Mantu Jain
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引用次数: 0

摘要

背景:2019冠状病毒病大流行影响着每个人的生活。印度从2020年3月25日起实施全国封锁。它对医疗保健服务系统产生了重大影响。双骨前臂骨折(BBFA)是常见的紧急情况。手术加钢板固定通常是成人和青少年的主要治疗方式。在第一波新冠肺炎大流行期间,封锁前接受手术的BBFA骨折患者的随访受到严重影响。为了了解缺乏定期随访对BBFA骨折患者预后的影响,在本研究中,我们评估了他们术后至少12个月的放射学、功能和临床结果。本研究探讨了手术治疗的BBFA骨折患者缺乏常规随访是否对其短期预后有任何影响。方法:我们纳入了30例在COVID-19封锁之前手术的BBFA骨折患者,并在手术后12个月评估其放射学、功能和临床结果。主观评估手臂、肩膀和手的快速残疾(QuickDASH)评分、患者评定腕部评估(PRWE)评分、Grace和Eversmann评分以及Mayo肘部表现指数(MEPI)评分。客观评估骨折部位压痛、腕、前臂、肘部和握力活动范围(ROM)。使用标准前臂正位和侧位x线片记录放射愈合。结果:随访时,28例患者骨折部位愈合,2例患者骨折不愈合。与未受伤前臂相比,受伤前臂的平均ROM在旋后(减少17.76%)、旋前(减少31.4%)、背屈(减少32%)、掌屈(减少24.6%)、肘关节屈伸弧度(减少2.5%)和握力(减少18%)方面显著降低。旋前和背屈的减少百分比分别高于旋后和掌屈。Grace和Eversmann评分为优16例,良4例,可接受7例,差3例。平均QuickDASH评分为6±6.6分。PRWE和MEPI的平均评分分别为7±4.5分和87.16分。MEPI评分优21例,良6例,一般2例,差1例。结论:采用加压钢板治疗成年BBFA骨折患者的临床、功能和影像学结果令人满意。在印度的COVID-19第一波期间,随访不足对他们的短期结果影响很小,甚至没有影响。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The impact of COVID-19 lockdown on the clinical and radiological outcomes of both-bone forearm fractures treated by compression plating at a tertiary care centre in India: a retrospective study.

Background: The COVID-19 pandemic has affected everyone's life. In India, the nationwide lockdown was enforced from March 25, 2020. It has significantly affected the healthcare delivery system. Both-bone forearm (BBFA) fractures are commonly encountered as an emergency. Surgical management with plate fixation is often the primary mode of management in adults and adolescents. During the first wave of the COVID-19 pandemic, follow-up of patients with BBFA fractures who had undergone surgery before the lockdown was severely affected. To understand the effect of lack of regular follow-up on the outcome of BBFA fracture patients, in this study, we assessed their radiological, functional, and clinical outcomes at least 12 months after surgery. This study examined if a lack of routine follow-ups in surgically treated BBFA fracture patients has any impact on their short-term outcomes.

Methods: We included 30 patients with BBFA fractures who were operated prior to the COVID-19 lockdown and assessed their radiological, functional, and clinical outcomes 12 months after surgery. Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) score, Patient-Rated Wrist Evaluation (PRWE) score, Grace and Eversmann's score, and Mayo Elbow Performance Index (MEPI) score were assessed subjectively. Fracture site tenderness, and wrist, forearm, elbow, and grip strength range of motion (ROM) were objectively evaluated. Radiological union was recorded using standard forearm anteroposterior and lateral radiography.

Results: At follow-up, 28 patients had union at the fracture site, and two patients had a nonunion. A significant reduction was observed in the mean ROM of the injured forearm compared with the uninjured forearm in supination (17.76% less), pronation (31.4% less), dorsiflexion (32% less), palmar-flexion (24.6% less), elbow flexion-extension arc (2.5% less), and grip strength (18% less). The percentage reduction in pronation and dorsiflexion was higher than that in supination and palmar-flexion, respectively. Grace and Eversmann's score was excellent in 16 patients, good in 4, acceptable in 7, and poor in 3 patients. The mean QuickDASH score was 6 ± 6.6. The mean PRWE and MEPI scores were 7 ± 4.5 and 87.16, respectively. The MEPI score was excellent in 21 patients, good in 6, fair in 2, and poor in 1 patient.

Conclusion: The clinical, functional, and radiological outcomes of adult patients with BBFA fractures who were treated with compression plating were satisfactory. Inadequate follow-up during the COVID-19 first wave in India had minimal to no effect on their short-term outcomes.

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