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跟骨外侧柱延长截骨术后的功能受限与生活质量降低相关。

Functional limitations after lateral column lengthening osteotomy of the calcaneus are associated with lower quality of life.

机构信息

Department of Orthopedics and Traumatology, University Hospital Basel, Spitalstrasse 21, 4031, Basel, Switzerland.

Department of Biomedical Engineering, University of Basel, Basel, Switzerland.

出版信息

Int Orthop. 2020 Jun;44(6):1091-1097. doi: 10.1007/s00264-020-04526-9. Epub 2020 Mar 13.

Abstract

PURPOSE

The purpose of this study was to quantify limitations in sagittal ankle range of motion (ROM) at least two years after lateral column lengthening osteotomy of the calcaneus (LLC) and their implications regarding quality of life.

METHODS

Fifteen patients with a mean follow-up of 80 ± 27 months after LLC and 15 age-matched healthy persons participated in this study. Ankle joint complex ROM in plantarflexion and dorsiflexion was measured bilaterally using a goniometer and fluoroscopy (patients only). Quality of life was assessed using the short-form health questionnaire (SF36). Differences in ROM parameters (for the tibiotalar and subtalar joint) between sides (affected vs. unaffected) and between groups (patient vs. controls) and the relationship between ROM parameters and quality of life scores were assessed.

RESULTS

ROM of the ankle joint complex on the affected side in patients was smaller than on the contralateral side (goniometer and fluoroscopy) and in healthy persons (goniometer; all P < .05). Among patients, SF36 total and pain scores, respectively, correlated with ROM of the subtalar joint (fluoroscopy; R = 0.379, P = 0.039 and R = 0.537, P = 0.001). Among patients and healthy persons, those with smaller dorsiflexion (goniometer) had lower quality of life scores.

CONCLUSIONS

The smaller sagittal ROM of the affected ankle joint complex compared with the contralateral foot and healthy controls was mainly explained by limitations in the tibiotalar joint. Because of its association with quality of life, ROM should be considered in the treatment and rehabilitation planning in patients who are candidates for LLC.

摘要

目的

本研究旨在定量分析距下外侧跟骨延长截骨术(LLC)后至少 2 年矢状面踝关节活动范围(ROM)的受限程度及其对生活质量的影响。

方法

本研究共纳入 15 例距骨 LLC 患者,平均随访 80±27 个月,同时纳入 15 名年龄匹配的健康对照者。使用量角器和透视(仅患者)双侧测量踝关节跖屈和背屈的关节复合体 ROM。使用健康调查简表(SF36)评估生活质量。评估侧别(患侧与健侧)和组间(患者与对照组)ROM 参数(距骨和跗骨间关节)的差异,以及 ROM 参数与生活质量评分之间的关系。

结果

患者患侧踝关节复合体 ROM 小于对侧(量角器和透视)和健康对照者(量角器;均 P<.05)。在患者中,SF36 总分和疼痛评分分别与跗骨间关节的 ROM(透视;R=0.379,P=0.039 和 R=0.537,P=0.001)相关。在患者和健康对照者中,背屈ROM 较小者(量角器)的生活质量评分较低。

结论

与健侧足和健康对照组相比,患侧踝关节复合体矢状面 ROM 较小,主要是由距骨和跟骨间关节活动受限引起。由于与生活质量相关,ROM 应在 LLC 候选患者的治疗和康复计划中考虑。

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