背景:内固定和外固定是治疗骨折的常见外科手术。然而,不同手术入路(包括内外固定)对患者心理状态和生活质量(QoL)的影响很少被研究.在这里,我们的目的是调查内外固定对焦虑的影响,抑郁症,失眠,桡骨远端骨折(DRF)患者的总体心理和身体健康。
方法:我们对96例接受内固定(57例)或外固定(39例)的骨折患者进行了回顾性研究。视觉模拟刻度(VAS),医院焦虑和抑郁量表(HADS),雅典失眠量表(AIS),和医学结果研究简短表格36(SF-36)问卷用于评估患者的疼痛,焦虑,抑郁症,睡眠,手术前和七天的生活质量,一个月,手术后三个月.
结果:术后第7天和1个月,内固定组(IFG)的VAS评分明显低于外固定组(EFG)(P<0.05)。尽管两组都没有表现出明显的焦虑,抑郁症,术前失眠(P>0.05),EFG显示出明显较高的HADS-A,HADS-D,术后7天、1个月和3个月AIS评分高于IFG(P<0.05)。此外,HADS-A的变化,HADS-D,EFG术后第7天AIS评分最显著(P<0.05)。此外,术前两组患者的平均身体成分汇总(PCS)和心理成分汇总(MCS)评分比较差异无统计学意义(P>0.05)。然而,两组患者在术后第7天、术后1个月和3个月时的PCS和MCS评分均呈阳性变化,与EFG相比,IFG具有显著更高的平均PCS和MCS得分(P<0.05)。
结论:与外固定架相比,内固定术后早期对患者的焦虑和抑郁情绪没有显著影响,术后康复期身心健康恢复较好。此外,当没有绝对的迹象时,对患者心理健康的影响应作为手术方式选择治疗方案的关键因素之一。
BACKGROUND: Internal and external fixation are common surgical procedures for treating fractures. However, the impact of different surgical approaches (including internal and external fixations) on patients\' psychological status and Quality of Life (QoL) is rarely examined. Herein, we aimed to investigate the effects of internal and external fixation on anxiety, depression, insomnia, and overall mental and physical health in Distal Radius Fractures (DRF) patients.
METHODS: We performed a retrospective study on 96 fracture patients who underwent internal fixation (57 patients) or external fixation (39 patients). The Visual Analog Scale (VAS), the Hospital Anxiety and Depression Scale (HADS), the Athens Insomnia Scale (AIS), and the Medical Outcomes Study Short Form 36 (SF-36) questionnaire were used to assess the patients\' pain, anxiety, depression, sleep, and QoL before surgery and at seven days, one month, and three months post-surgery.
RESULTS: The VAS scores were significantly lower in the Internal Fixation Group (IFG) than in the External Fixation Group (EFG) on the seventh day and one month postoperatively (P < 0.05). Although both groups showed no significant anxiety, depression, or insomnia before surgery (P > 0.05), the EFG showed significantly higher HADS-A, HADS-D, and AIS scores than the IFG at seven days and one and three months postoperatively (P < 0.05). Additionally, changes in HADS-A, HADS-D, and AIS scores were most significant at day seven post-surgery in the EFG (P < 0.05). Furthermore, no significant difference was found between the two groups in the average Physical Component Summary (PCS) and Mental Component Summary (MCS) scores before surgery (P > 0.05). However, both groups showed positive changes in PCS and MCS scores at postoperative day seven and one and three months postoperatively, with the IFG having significantly higher average PCS and MCS scores compared to the EFG (P < 0.05).
CONCLUSIONS: Compared to external fixation, internal fixation did not significantly impact patients\' emotions regarding anxiety and depression in the early postoperative period, and physical and mental health recovery was better during the postoperative rehabilitation period. Furthermore, when there are no absolute indications, the impact on patients\' psychological well-being should be considered as one of the key factors in the treatment plan during surgical approach selection.