橈骨遠位端骨折患者の手の使用満足度と手関節機能および生活における手の実用度の関連

Relationship between satisfaction with hand use, wrist joint function, and practical use of the hand in daily life among patients with distal radius fracture

要旨：橈骨遠位端骨折後掌側ロッキングプレート固定術施行患者47名を対象に，術後12週時の手の使用満足度に関連する要因を明らかにすることを目的とし，横断研究を行った．従属変数を手の使用満足度，独立変数を患者属性，手関節機能，生活における手の実用度とした重回帰分析，アンケートの自由記載による質的記述的分析を行った．重回帰分析より，手の使用満足度には生活における手の実用度が最も関連を示し，質的記述的分析では，仕事への参加状況や心理的影響の関連が示され，これらの改善が有用であることが示唆された．作業療法を通して，対象者に応じた生活動作の獲得の他，患者教育により手の自己管理能力を高める必要があると考えられた．

　This cross-sectional study aimed to identify factors associated with hand-use satisfaction at 12 weeks postoperatively in 47 patients who underwent volar locking plate fixation for distal radius fractures. Multiple regression analyses were conducted with hand-use satisfaction as the dependent variable, and patient demographics, wrist function, and practical hand use in daily life as independent variables. In addition, qualitative descriptive method analyses were performed based on open-ended responses from a questionnaire. The multiple regression analyses revealed that practical hand use in daily life was the most significant factor related to hand-use satisfaction. The qualitative analyses indicated that work participation and psychological impact were also associated with satisfaction, suggesting that improvements in these areas could be beneficial. These findings imply that, through occupational therapy, it is essential not only to assist patients in regaining daily functional tasks tailored to their needs, but also to enhance their self-management abilities of hand function through patient education.