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术后 3-6 年闭合性 Weber B 踝关节骨折手术治疗的功能结果,是否伴有下胫腓联合固定。

Functional outcome 3-6 years after operative treatment of closed Weber B ankle fractures with or without syndesmotic fixation.

机构信息

Department of Orthopaedics, Akershus University Hospital, Norway; Institute of Clinical Medicine, University of Oslo, Norway.

Department of Orthopaedics, Østfold Hospital, Norway.

出版信息

Foot Ankle Surg. 2020 Jun;26(4):378-383. doi: 10.1016/j.fas.2019.04.013. Epub 2019 May 4.

Abstract

BACKGROUND

To compare the long-term functional outcomes of patients surgically treated for Weber B ankle fractures with or without syndesmotic fixation.

METHODS

In total, 959 adult patients with previous treatment with open reduction and internal fixation (ORIF) for closed ankle fractures were eligible for inclusion in a cross-sectional postal survey 3-6 years after surgery; 645 had Weber B fractures. The survey assessed functional outcomes with three validated ankle questionnaires.

RESULTS

In total 365 (57%) patients responded at a median of 4.2 years after the trauma. After adjusting for age, sex, education, smoking status, body mass index, diabetes, physical status before surgery, fracture classification, and duration of surgery, patients with a syndesmotic fixation had no different OMAS score (p = 0.98), LEFS score (p = 0.61), and SEFAS score (p = 0.98) than those without a syndesmotic fixation. Trimalleolar fracture was associated with worse functional outcomes than unimalleolar on two of the scales, the OMAS (p = 0.028) and LEFS (p = 0.046).

CONCLUSIONS

In multivariable analysis, patients with a syndesmotic fixation had no worse long-term functional outcomes than those without syndesmotic fixation.

摘要

背景

比较手术治疗 Weber B 型踝关节骨折患者是否固定下胫腓联合的长期功能结果。

方法

共有 959 名接受过切开复位内固定 (ORIF) 治疗闭合性踝关节骨折的成年患者符合横断面邮寄调查的纳入标准,手术 3-6 年后进行;其中 645 例为 Weber B 型骨折。该调查使用三个经过验证的踝关节问卷评估功能结果。

结果

共有 365 名(57%)患者在创伤后中位数 4.2 年时做出了回应。在调整年龄、性别、教育程度、吸烟状况、体重指数、糖尿病、术前身体状况、骨折分类和手术时间后,固定下胫腓联合的患者在 OMAS 评分(p=0.98)、LEFS 评分(p=0.61)和 SEFAS 评分(p=0.98)方面与未固定下胫腓联合的患者没有差异。三踝骨折在两个评分中,即 OMAS(p=0.028)和 LEFS(p=0.046),比单踝骨折的功能结果更差。

结论

在多变量分析中,固定下胫腓联合的患者的长期功能结果并不比未固定下胫腓联合的患者差。

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