Karkkola Sini, Kortekangas Tero, Pakarinen Harri, Flinkkilä Tapio, Niinimäki Jaakko, Leskelä Hannu-Ville
Division of Orthopedic and Trauma Surgery, Department of Surgery, Oulu University Hospital, Oulu, Finland.
Medical Research Center, University of Oulu, Oulu, Finland .
J Orthop Trauma. 2021 May 1;35(5):227-233. doi: 10.1097/BOT.0000000000001959.
To assess the long-term functional and radiological outcome, as well as complications and reoperations of ankle fracture patients treated based on stability classification.
Retrospective.
Main Trauma Center, University Hospital.
One hundred sixty patients were treated based on stability classification. After a mean follow-up of 12 years, 102 patients were assessed; 67 visited the outpatient clinic, and standard standing ankle radiographs were taken; osteoarthritis (OA) was graded according to Kellgren-Lawrence classification. The remaining patients (n = 35) were followed up via mail or telephone. The complications and reoperations of all 160 patients were collected from electronic patient records.
Olerud-Molander ankle score, foot and ankle outcome score, visual analog scale, RAND-36 item health survey, range-of-motion measurements, and Kellgren-Lawrence OA classification.
Very good to excellent ankle functional outcome was reported by 96% of the stable fracture group [mean Olerud-Molander ankle score (OMAS), 92; range, 20-100] and 82% of the unstable group (mean OMAS, 86; range, 30-100). For patients with an unstable fracture, OMAS and VAS pain scores significantly improved from 2 to 12 years, even though higher grades of radiologic OA were found. No patients with fractures deemed stable needed operative intervention even in the long-term follow-up. Instead, 30% of the operatively treated patients underwent reoperation during the long follow-up.
The treatment of ankle fractures based on stability-based classification led to predictable, functionally good outcomes even during long-term follow-up. Ankle fractures can reliably be deemed stable based on this classification and treated without failures in the long term.
Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
评估基于稳定性分类治疗的踝关节骨折患者的长期功能和影像学结果，以及并发症和再次手术情况。
回顾性研究。
大学医院主要创伤中心。
160例患者基于稳定性分类进行治疗。平均随访12年后，对102例患者进行评估；67例患者到门诊就诊，并拍摄标准站立位踝关节X线片；根据凯尔格伦-劳伦斯分类法对骨关节炎（OA）进行分级。其余患者（n = 35）通过邮件或电话进行随访。从电子病历中收集所有160例患者的并发症和再次手术情况。
奥勒鲁德-莫兰德踝关节评分、足踝结局评分、视觉模拟量表、兰德36项健康调查、活动度测量以及凯尔格伦-劳伦斯OA分类。
稳定骨折组96%的患者报告踝关节功能结局非常好至优秀[平均奥勒鲁德-莫兰德踝关节评分（OMAS），92分；范围，20 - 100分]，不稳定组为82%（平均OMAS，86分；范围，30 - 100分）。对于不稳定骨折患者，尽管发现放射学OA等级较高，但OMAS和视觉模拟量表疼痛评分从2年到12年有显著改善。即使在长期随访中，被认为稳定的骨折患者也无需手术干预。相反，30%接受手术治疗的患者在长期随访期间接受了再次手术。
基于稳定性分类治疗踝关节骨折即使在长期随访中也能带来可预测的、功能良好的结果。基于这种分类，踝关节骨折可可靠地被视为稳定，且长期治疗无失败情况。
治疗性III级。有关证据水平的完整描述，请参阅作者指南。
