Schneider Wolfgang, Jurenitsch Stefan
Orthopaedic Department, Herz Jesu-Hospital, Baumgasse 20A, 1030, Vienna, Austria.
Int Orthop. 2016 Feb;40(2):301-6. doi: 10.1007/s00264-015-3066-2. Epub 2015 Dec 16.
Despite some theoretical reservations, the AOFAS clinical rating system with its scales for ankle-hindfoot, midfoot, hallux and lesser toes is one of the most widely used assessment tools in foot and ankle surgery. This study was designed to generate age- and gender-related norm values for all four subscales.
Despite not being used in a self-administered manner, the AOFAS score underwent cross cultural adaptation to guarantee unrestricted comparability of data. A data pool was generated using the results of personal interviews and clinical examination of 625 individuals, including staff and visitors to our hospital, and excluding people scheduled for foot surgery or in after-treatment. These data served as a basis to calculate all four parts of the AOFAS clinical rating system.
Mean value for the ankle-hindfoot scale was calculated as 91.6 points (±0.9 confidence interval), and 89.3 points for the midfoot scale (±1.0 CI), 88.3 for the hallux metatarsophalangeal-interphalangeal scale (± 0.9 CI) and 91.0 for the lesser metatarsophalangeal-interphalangeal scale (± 0.8 CI). Results showed a decrease with age in all four scales. Males showed better results than females. Individuals with previous surgery showed lower results in the respective score.
While lowered scoring results prior to surgery reflect the degree of restrictions due to pain, function and alignment problems, post-operative increases in clinical scoring should indicate return to age-related norm values. Our data calculated these norm values for the first time for all four AOFAS scales, giving a basis for better interpretation of published results in foot and ankle surgery. Our data showed and quantified the decrease of norm values with age, especially for hallux and lesser toes scores, as well as lower norm values for females and for individuals that had had surgery of the foot.
Level I, diagnostic study.
尽管存在一些理论上的保留意见，但美国足踝外科协会（AOFAS）临床评分系统及其针对踝-后足、中足、拇趾和小趾的量表仍是足踝外科手术中使用最广泛的评估工具之一。本研究旨在生成这四个子量表与年龄和性别相关的常模值。
尽管AOFAS评分并非以自我管理的方式使用，但对其进行了跨文化改编，以确保数据具有不受限制的可比性。通过对625名个体（包括我院工作人员和访客）进行个人访谈和临床检查的结果建立了一个数据库，排除了计划进行足部手术或处于术后治疗阶段的人员。这些数据作为计算AOFAS临床评分系统所有四个部分的基础。
踝-后足量表的平均值计算为91.6分（±0.9置信区间），中足量表为89.3分（±1.0置信区间），拇趾跖趾-趾间关节量表为88.3分（±0.9置信区间），小趾跖趾-趾间关节量表为91.0分（±0.8置信区间）。结果显示，所有四个量表的得分均随年龄增长而下降。男性的结果优于女性。既往接受过手术的个体在相应评分中得分较低。
术前评分降低反映了疼痛、功能和对线问题导致功能受限的程度，而术后临床评分的增加应表明恢复到与年龄相关的常模值。我们的数据首次计算了AOFAS所有四个量表的这些常模值，为更好地解释足踝外科手术中已发表的结果提供了依据。我们的数据显示并量化了常模值随年龄的下降，尤其是拇趾和小趾评分，以及女性和接受过足部手术的个体的常模值较低。
I级，诊断性研究。
