Chummun Shaheel, Wright Thomas C, Chapman Thomas W L, Khan Umraz
Department of Plastic Surgery, North Bristol NHS Trust, Bristol, UK.
Department of Plastic Surgery, North Bristol NHS Trust, Bristol, UK.
Injury. 2015;46(6):1112-5. doi: 10.1016/j.injury.2014.12.017. Epub 2014 Dec 25.
We reviewed the functional outcome of 68 patients with open ankle fractures managed in an orthoplastic specialist centre.
Patients managed at Frenchay Hospital over a 6 year period were divided into 3 groups: group P were patients initially seen and managed at Frenchay Hospital (an orthoplastic specialist centre), group S were patients stabilised at a different unit and referred for definitive management, while group R were patients managed in a different unit and referred following complications. Injuries were graded using the AO score and outcome was measured using the Enneking score (both validated).
19 patients (group P, mean age: 43 years), 26 patients (group S, mean age: 41 years) and 23 patients (group R, mean age: 41.9 years) made the cohort. 82.4% patients required free tissue transfer. Mean AO scores of groups P, S and R were 11.5, 12.3 and 9.7 (p+0.03). Mean number of procedures for P, S and R were 2.6, 3.5 and 4.2 (p = 0.0006). Mean follow up time was 55.5, 61.0 and 57.0 weeks respectively (p = 0.72). Mean Enneking scores for groups P, S and R were 63.3, 74.8 and 73.5 (p = 0.16).
Patients from groups S and R underwent more procedures. However, a similar outcome can be achieved, highlighting the importance of managing such injuries in an orthoplastic specialist centre.
我们回顾了在一家整形专科中心接受治疗的68例开放性踝关节骨折患者的功能预后情况。
在六年时间里于弗伦奇医院接受治疗的患者被分为三组:P组为最初在弗伦奇医院(一家整形专科中心)就诊并接受治疗的患者;S组为在其他科室接受固定治疗后转诊至本院接受最终治疗的患者;R组为在其他科室接受治疗后因出现并发症而转诊至本院的患者。损伤情况采用AO评分进行分级,预后情况采用恩内金评分进行评估(两者均为有效评分系统)。
该队列包括19例患者(P组,平均年龄:43岁)、26例患者(S组,平均年龄:41岁)和23例患者(R组,平均年龄:41.9岁)。82.4%的患者需要进行游离组织移植。P组、S组和R组的平均AO评分分别为11.5、12.3和9.7(p = 0.03)。P组、S组和R组的平均手术次数分别为2.6、3.5和4.2(p = 0.0006)。平均随访时间分别为55.5周、61.0周和57.0周(p = 0.72)。P组、S组和R组的平均恩内金评分分别为63.3、74.8和73.5(p = 0.16)。
S组和R组的患者接受了更多的手术。然而,可以取得相似的预后结果,这凸显了在整形专科中心处理此类损伤的重要性。