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临床和影像学预测因素对距外侧踝关节扭伤 5 年后持续性症状的影响:初级保健中长期随访研究。

Clinical and radiological predictors for persistent complaints five years after a lateral ankle sprain: A long-term follow-up study in primary care.

机构信息

Department of General Practice, Erasmus MC University Medical Center, The Netherlands,.

Department of Radiology, Erasmus MC University Medical Center, The Netherlands.

出版信息

J Sci Med Sport. 2018 Mar;21(3):250-256. doi: 10.1016/j.jsams.2017.07.005. Epub 2017 Jul 23.

DOI:10.1016/j.jsams.2017.07.005
PMID:28780197
Abstract

OBJECTIVES

To examine the five-year prognosis and potential prognostic factors of patients with an acute lateral ankle sprain in primary care setting.

DESIGN

Observational study.

METHODS

206 patients who participated in a cross-sectional study and visited their general practitioner with an acute lateral ankle sprain 6-12 months prior to inclusion were approached for a 5-year follow-up measurement consisting of an online questionnaire. At baseline patients completed standardized questionnaires, underwent a standardized physical examination and radiological examination (radiography and Magnetic Resonance Imaging) and scored their perceived recovery. Logistic regression analysis was used to examine potential predictive factors at baseline for the presence of persistent complaints after 5 years.

RESULTS

132 (64.1%) patients completed the 5-year follow-up. 18.2% reported persistent complaints and 30.3% had a re-sprain during follow-up. Baseline persistent complaints 6-12 months after an acute lateral ankle sprain (OR 6.38; CI 95% 1.54-26.44), dominant leg injury (OR 4.89; CI 95% 1.16-20.62) and a recurrent ankle sprain (OR 9.81; CI 95% 2.17-44.47) were significant predictors for persistent complaints 5 years after an acute ankle sprain. Physical examination and radiological findings did not add to the predictive value of the prognostic model.

CONCLUSIONS

Almost 20% of patients with an acute lateral ankle sprain experience persistent complaints after 5 years follow-up. Predictive factors for persistent complaints can be identified.

摘要

目的

在初级保健环境中检查急性外踝扭伤患者的五年预后和潜在预后因素。

设计

观察性研究。

方法

对 206 名患者进行了横断面研究,他们在纳入前 6-12 个月曾因急性外踝扭伤就诊于全科医生,进行了为期 5 年的随访测量,包括在线问卷调查。在基线时,患者完成了标准化问卷,接受了标准化的体格检查和影像学检查(X 线和磁共振成像),并对他们的感知恢复情况进行了评分。逻辑回归分析用于检查基线时的潜在预测因素,以预测 5 年后是否存在持续的抱怨。

结果

132 名(64.1%)患者完成了 5 年随访。18.2%报告有持续的抱怨,30.3%在随访期间再次扭伤。急性外踝扭伤后 6-12 个月持续抱怨(OR 6.38;95%CI 1.54-26.44)、优势腿损伤(OR 4.89;95%CI 1.16-20.62)和复发性踝关节扭伤(OR 9.81;95%CI 2.17-44.47)是急性踝关节扭伤后 5 年持续抱怨的显著预测因素。体格检查和影像学发现并未增加预后模型的预测价值。

结论

近 20%的急性外踝扭伤患者在 5 年随访后仍有持续的抱怨。可以确定持续抱怨的预测因素。

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