Nilsson Gertrud, Nyberg Per, Ekdahl Charlotte, Eneroth Magnus
Research Department, Lund University Hospital, Department of Physical Therapy, Lund University, Sweden.
Physiother Res Int. 2003;8(2):69-82. doi: 10.1002/pri.274.
Few studies have been published that extensively evaluate physical outcome after ankle fractures. In addition, there is a lack of knowledge of how physical outcome correlates with subjective assessments of symptoms and function after ankle fracture. The purpose of the present study was to investigate outcome after surgical treatment of patients with ankle fracture and to study how well the experience of symptoms and function correlated with the results of clinical physical tests.
The study used a retrospective cross-sectional study design. Fifty-four patients, aged 17-64 years, were evaluated 14 months post-operatively. Evaluation included a questionnaire containing the Olerud-Molander Ankle Score (OMAS) (Olerud and Molander, 1984) and some additional questions. Patients were also called for a physical and radiographic examination.
The median OMAS obtained was 75 (range 10-100). Only 10 (19%) of the patients reported complete recovery and 16 (30%) scored > or = 90, indicating good function. The results of the following clinical tests were correlated with OMAS: loaded dorsal extension; ankle circumference; number of toe and heel rises; and single-limb stance. Those who showed poorer results in physical outcome on the affected side had lower OMAS. No ankles with clear mechanical instability were found, although almost half the patients experienced functional instability that, in turn, was associated with decreased total OMAS.
Both subjectively scored function and physical performance after surgically treated ankle fractures indicated poor results. One reason for this might be insufficient rehabilitation.
很少有已发表的研究广泛评估踝关节骨折后的身体状况。此外，对于踝关节骨折后身体状况如何与症状和功能的主观评估相关联，人们了解不足。本研究的目的是调查踝关节骨折患者手术治疗后的结果，并研究症状和功能体验与临床物理检查结果的关联程度。
本研究采用回顾性横断面研究设计。对54名年龄在17至64岁之间的患者进行术后14个月的评估。评估包括一份包含奥勒鲁德 - 莫兰德踝关节评分（OMAS）（奥勒鲁德和莫兰德，1984年）及一些附加问题的问卷。还要求患者进行体格检查和影像学检查。
获得的OMAS中位数为75（范围10 - 100）。只有10名（19%）患者报告完全康复，16名（30%）患者评分≥90，表明功能良好。以下临床检查结果与OMAS相关：负重背伸；踝关节周长；脚趾和脚跟抬起次数；以及单腿站立。患侧身体状况结果较差的患者OMAS较低。未发现有明显机械不稳定的踝关节，尽管几乎一半的患者经历了功能不稳定，而这又与总OMAS降低相关。
手术治疗的踝关节骨折后，主观评分的功能和身体表现均显示结果不佳。其原因之一可能是康复不足。
