Department of Orthopaedic Surgery, MetroHealth System, Affiliated with Case Reserve University, Cleveland, OH.
J Orthop Trauma. 2021 Jun 1;35(6):e195-e201. doi: 10.1097/BOT.0000000000001992.
To compare complications and functional outcomes between supination adduction type II (SAD) injuries and torsional ankle injuries (TAI).
Retrospective cohort.
Level 1 trauma center.
Patients (n = 1531) treated for ankle fractures (OTA/AO 43B or 44) over 16 years were identified. The most recent 200 consecutive adult patients treated for TAI (OTA/AO 44, not SAD) served as controls.
Complications, unplanned secondary procedures, and patient-reported functional outcome scores, as measured by the Foot Function Index and Short Musculoskeletal Function Assessment.
Sixty-five patients with SAD injuries (4.2%) were included. They were younger (43.2 vs. 47.7 years, P = 0.08) and more commonly involved in a motorized collision, (58.5% vs. 29.0%) and more often multiply injured: other orthopaedic injuries (66.2% vs. 31.0%) and other nonorthopaedic injuries (40.0% vs. 7.5%, all P < 0.001 vs. TAI). Overall complication and unplanned secondary procedure rates were not different between groups. Those with a SAD injury had more posttraumatic arthrosis (80.0% vs. 40.9%, P = 0.004), but no differences were noted in infection, wound healing, malunion, or nonunion. The mean functional outcome scores were worse for SAD patients over 6 years after injury among all the Foot Function Index and Short Musculoskeletal Function Assessment categories; however, these differences were not significant.
SAD injuries represented 4.2% of all ankle fractures, occurring in younger patients through higher-energy mechanisms and more often associated with polytrauma. Despite 80% of SAD patients developing posttraumatic arthrosis, secondary procedures were not more common, and functional outcomes after a SAD injury were not different from TAI.
Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
比较旋后内收型Ⅱ型（SAD）损伤和扭转踝关节损伤（TAI）的并发症和功能结果。
回顾性队列研究。
1 级创伤中心。
确定了 16 年来接受踝关节骨折（OTA/AO 43B 或 44）治疗的患者（n=1531）。最近 200 例连续接受 TAI（OTA/AO 44，非 SAD）治疗的成年患者作为对照。
并发症、计划外二次手术以及患者报告的功能结果评分，采用足功能指数和短肌肉骨骼功能评估进行测量。
65 例 SAD 损伤患者（4.2%）纳入研究。他们更年轻（43.2 岁比 47.7 岁，P=0.08），更常见于机动车碰撞（58.5%比 29.0%），更常多发伤：其他骨科损伤（66.2%比 31.0%）和其他非骨科损伤（40.0%比 7.5%，均 P<0.001 比 TAI）。两组的总体并发症和计划外二次手术率没有差异。SAD 损伤患者的创伤后关节炎更多（80.0%比 40.9%，P=0.004），但感染、伤口愈合、畸形愈合或骨不连的发生率没有差异。SAD 患者在伤后 6 年的所有足功能指数和短肌肉骨骼功能评估类别中的功能结果评分均较差；然而，这些差异没有统计学意义。
SAD 损伤占所有踝关节骨折的 4.2%，发生在年轻患者，通过更高能量的机制，更常与多发伤相关。尽管 80%的 SAD 患者发生创伤后关节炎，但二次手术并不更常见，SAD 损伤后的功能结果与 TAI 无差异。
预后 III 级。有关证据水平的完整描述，请参见作者说明。
