伴有和不伴有下胫腓联合损伤的Weber B型踝关节骨折的中长期预后
Mid- to Long-term Outcomes After Weber B-type Ankle Fractures With and Without Syndesmotic Rupture.
作者信息
Kohake Michael B J, Wiebking Ulrich, O'Loughlin Padhraig F, Krettek Christian, Gaulke Ralph
机构信息
Section Upper Extremity, Foot- and Rheuma Surgery, Trauma Department, Medical School Hanover (MHH), Hanover, Germany.
Trauma Department, Medical School Hanover (MHH), Hanover, Germany.
出版信息
In Vivo. 2019 Jan-Feb;33(1):255-261. doi: 10.21873/invivo.11469.
BACKGROUND/AIM: The aim of the present study was to assess the impact of syndesmotic screw fixation on overall clinical outcomes following Weber B-type ankle fractures.
MATERIALS AND METHODS
A total of 21 patients with syndesmotic rupture requiring screw fixation were compared to 40 patients with an intact syndesmosis. Olerud-Molander-Ankle-Score, American Orthopedic Foot & Ankle Society ankle hindfoot score, and the Short Form Health Survey-36 were recorded. Weight-bearing plain radiographs were performed to rate post traumatic osteoarthrosis according to the Kellgren-Lawrence score. Pain levels were evaluated with a visual analog scale.
RESULTS
A total of 61 patients with a mean follow-up of 6.6 years (range=2-12 years) satisfied the inclusion criteria. Pain level, clinical outcome scores, and radiographs did not reveal significant differences between the groups. Ankle joints with syndesmotic rupture showed a significant restriction in dorsiflexion compared to those with an intact syndesmosis (15 vs. 20°, p=0.028).
CONCLUSION
Syndesmotic rupture does not affect clinical and radiological outcome parameters following Weber B-type ankle fractures, but does lead to a significant restriction in dorsiflexion of the ankle joint.
背景/目的：本研究旨在评估下胫腓螺钉固定对Weber B型踝关节骨折整体临床疗效的影响。
材料与方法
将21例需要螺钉固定的下胫腓联合损伤患者与40例下胫腓联合完整的患者进行比较。记录Olerud-Molander踝关节评分、美国矫形足踝协会踝后足评分以及简短健康调查问卷-36。进行负重X线平片检查，根据Kellgren-Lawrence评分对创伤后骨关节炎进行分级。采用视觉模拟量表评估疼痛程度。
结果
共有61例患者符合纳入标准，平均随访6.6年（范围2 - 12年）。两组之间的疼痛程度、临床疗效评分及X线检查结果均无显著差异。与下胫腓联合完整的踝关节相比，下胫腓联合损伤的踝关节背屈明显受限（15°对20°，p = 0.028）。
结论
下胫腓联合损伤不影响Weber B型踝关节骨折后的临床及影像学结果参数，但会导致踝关节背屈明显受限。
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