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手术治疗移位性关节内跟骨骨折的预后决定因素

Outcome Determining Factors for displaced Intra-articular Calcaneal Fractures treated operatively.

作者信息

Nawfar S A, Chan K L, Idham H M, Izani I M, Nahulan T

机构信息

Department of Orthopaedics, Universiti Sains Malaysia, Kubang Kerian, Malaysia.

Department of Orthopaedics, Queen Elizabeth Hospital, Kota Kinabalu, Malaysia.

出版信息

Malays Orthop J. 2015 Nov;9(3):8-16. doi: 10.5704/MOJ.1511.001.

Abstract

INTRODUCTION

Calcaneal fractures are caused by high energy trauma and mostly are intra-articular fractures. Nondisplaced intra-articular calcaneal fracture (IACF) can be treated non-operatively. However, displaced intra-articular need to be reduced and fixed anatomically to facilitate early ankle rehabilitation and minimize functional impairment. This study was done to find out the outcome of the IACF patients who underwent operative treatment.

METHODS

62 patients with IACF were selected in this study and had been followed up from June 2009 to May 2013. They were placed into two groups; the operative treated and non-operative treated groups. Bilateral ankle lateral view plain radiographs were taken for comparison of the Bohler and Gissane angles. Both groups of patients were assessed by the Maryland Foot Score (MFS) and the SF-36v2 general health survey questionnaire. The ability of the patients to perform activity of daily living (ADL) and /or return to work (RTW) was assessed as well.

RESULTS

The operative treatment group of displaced IACF patients achieved no significant better scores in the mean MFS and SF-36v2 mean scores as compared to non operated cases. There was no difference in RTW between the 2 groups, but earlier ADL was recorded in the operated group. However, this study had found 5 associated factors which causes major effect to the patients' outcome to treatment.

CONCLUSIONS

The patient's compliance with post-operative rehabilitation regimen were found to be significantly related with the outcomes.

摘要

引言

跟骨骨折由高能创伤引起,多为关节内骨折。无移位的关节内跟骨骨折(IACF)可采用非手术治疗。然而,移位的关节内骨折需要进行解剖复位和固定,以促进早期踝关节康复并减少功能障碍。本研究旨在了解接受手术治疗的IACF患者的治疗结果。

方法

本研究选取了62例IACF患者,随访时间为2009年6月至2013年5月。他们被分为两组,即手术治疗组和非手术治疗组。拍摄双侧踝关节侧位X线平片以比较Bohler角和Gissane角。两组患者均通过马里兰足部评分(MFS)和SF-36v2一般健康调查问卷进行评估。还评估了患者进行日常生活活动(ADL)和/或重返工作岗位(RTW)的能力。

结果

与未手术的病例相比,移位IACF患者的手术治疗组在平均MFS和SF-36v2平均评分方面没有显著更好的分数。两组之间的RTW没有差异,但手术组的ADL记录更早。然而,本研究发现了5个对患者治疗结果有重大影响的相关因素。

结论

发现患者对术后康复方案的依从性与治疗结果显著相关。

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