Keck School of Medicine of the University of Southern California, Department of Orthopaedic Surgery, 1520 San Pablo Street, Suite 2000, Los Angeles, CA 90033, United States.
Keck School of Medicine of the University of Southern California, Department of Orthopaedic Surgery, 1520 San Pablo Street, Suite 2000, Los Angeles, CA 90033, United States.
Injury. 2020 Jun;51(6):1387-1391. doi: 10.1016/j.injury.2020.03.032. Epub 2020 Mar 13.
There are few published studies that investigate the surgical treatment of supination-adduction (SAD, AO/OTA 44A2.3) ankle fractures. The purpose of this study was to describe the complications and outcomes following operative fixation of SAD type 2 ankle fractures.
We identified all SAD-2 ankle fractures that presented at our institution's two hospitals from 2006-2018. Demographics, operative data, and complications (deep infection, superficial infection, delayed union, failure of fixation, and unplanned reoperation) were recorded for all patients. Lastly, all included patients were contacted by telephone for the administration of an 8-question Patient-Reported Outcomes Measurement Information System (PROMIS) Physical Function (PF) and Pain Interference questionnaire (PI). Univariate and multivariate analysis was performed to identify risk factors for complication or poor functional outcome score.
65 patients met inclusion criteria. The average time to surgery was 14 days and average follow-up was 20.5 (range: 0.4-60.9) weeks. There were 9 (13.8%) complications (4 deep infections, 3 superficial infections, 1 delayed union, 1 failure of fixation) and 6 unplanned reoperations. Univariate and multivariate analysis failed to identify any statistically significant risk factors for complication or reoperation. Eleven patients participated in the administration of PROMIS score questionnaires at a mean of 3.4 years postoperatively. The average PROMIS Physical Function T-score was 42.3 ± 11.3 and the average PROMIS Pain Interference T-score was 55.8 ± 7.8. Younger age was associated with a higher physical function score. The use of a direct medial approach to the medial malleolus was associated with a lower pain interference score.
The overall complication rate for SAD (OTA/AO 44A2.3) type 2 ankle fractures is similar to that of the general ankle fracture population. We were unable to identify risk factors for complication or reoperation. Mean patient reported outcomes are within one standard deviation of the general population.
III, retrospective cohort study.
很少有发表的研究调查旋前-内收（SAD，AO/OTA 44A2.3）踝关节骨折的手术治疗。本研究的目的是描述 SAD 2 型踝关节骨折手术固定后的并发症和结果。
我们从 2006 年至 2018 年在我们机构的两家医院确定了所有 SAD-2 踝关节骨折患者。记录所有患者的人口统计学、手术数据和并发症（深部感染、浅表感染、延迟愈合、固定失败和计划外再次手术）。最后，通过电话联系所有纳入的患者，进行 8 项患者报告的结局测量信息系统（PROMIS）物理功能（PF）和疼痛干扰问卷（PI）的问卷调查。进行单变量和多变量分析，以确定并发症或功能结局评分差的危险因素。
65 名患者符合纳入标准。手术平均时间为 14 天，平均随访时间为 20.5（范围：0.4-60.9）周。有 9 例（13.8%）并发症（4 例深部感染，3 例浅表感染，1 例延迟愈合，1 例固定失败）和 6 例计划外再次手术。单变量和多变量分析均未能确定并发症或再次手术的任何统计学显著危险因素。11 名患者在术后平均 3.4 年接受了 PROMIS 评分问卷的管理。平均 PROMIS 物理功能 T 评分 42.3±11.3，平均 PROMIS 疼痛干扰 T 评分 55.8±7.8。年龄较小与较高的物理功能评分相关。使用直接内侧入路治疗内踝与较低的疼痛干扰评分相关。
SAD（OTA/AO 44A2.3）2 型踝关节骨折的总体并发症发生率与一般踝关节骨折患者相似。我们无法确定并发症或再次手术的危险因素。患者报告的平均结果在一般人群的一个标准差内。
III，回顾性队列研究。
