University Clinic of Traumatology - Medical faculty of Skopje, North Macedonia, Macedonia.
Trauma and Orthopaedics Department, Medical University Hospital LKH Graz, Austria.
Injury. 2021 Sep;52 Suppl 5:S70-S74. doi: 10.1016/j.injury.2021.04.047. Epub 2021 Apr 17.
A few radiographic techniques have been proposed to evaluate ankle syndesmosis reduction. The purpose of this study was to analyze post-operatively with CT-scanning the quality of ankle syndesmotic reduction. Moreover, to assess the impact of quality of syndesmotic reduction to functional outcome.
A prospective cohort study focused on patients older than 17 years with lateral and medial malleolar fracture with verified syndesmotic disruption.
open fracture, concomitant injury, surgery delayed for more than 24 hours, additional posterior malleolar fracture, ASA score of ≥ 3, complication requiring revision surgery, articular step or gap of ≥ 2mm on the postoperative CT scans.
Out of 41 patients, 34 participants completed the follow-up. There was a male predominance (20 patients - 58.82%) and the mean age was 48.46±16.1 years (range (20-72 years). 22 patients (64.71%) have sustained type B fracture, while in 12 patients (35.29%) the fracture was of a type C. The reduction was classified as anatomical in 26 patients (76.50%), while in 8 patients (23.50%) the reduction of the syndesmosis was non-anatomical. In those 26 patients in whom the reduction was anatomical, 17 (65.39%) were males and there were 18 (66.67%) type B fractures. In the patients with non-anatomical reduction, 3 patients (37.5%) were of a male gender and there was the equal number of type B and C fractures. The statistical analysis showed significantly favorable scores for both AOFAS score and VAS scale for the patients with anatomical reduction.
Functional analysis showed a strong association with the CT observed reduction quality and both the AOFAS score and VAS scale. Further studies are desirable to provide further evidence in relation to the findings of this study.
已经提出了几种放射影像学技术来评估踝关节联合复位。本研究的目的是通过 CT 扫描术后分析踝关节联合复位的质量。此外，评估联合复位质量对功能结果的影响。
一项针对年龄大于 17 岁的外侧和内侧踝骨骨折且经证实存在联合分离的患者的前瞻性队列研究。
开放性骨折、合并损伤、手术延迟超过 24 小时、伴有后踝骨折、ASA 评分≥3、需要修正手术的并发症、术后 CT 扫描显示关节台阶或间隙≥2mm。
41 例患者中，34 例完成了随访。男性居多（20 例-58.82%），平均年龄为 48.46±16.1 岁（范围 20-72 岁）。22 例（64.71%）患者为 B 型骨折，12 例（35.29%）为 C 型骨折。26 例（76.50%）患者的复位为解剖复位，8 例（23.50%）为非解剖复位。在 26 例解剖复位的患者中，17 例（65.39%）为男性，18 例（66.67%）为 B 型骨折。在非解剖复位的患者中，3 例（37.5%）为男性，B 型和 C 型骨折数量相等。统计学分析显示，解剖复位患者的 AOFAS 评分和 VAS 评分均明显较好。
功能分析显示与 CT 观察到的复位质量有很强的相关性，AOFAS 评分和 VAS 评分也是如此。需要进一步的研究来提供更多与本研究结果相关的证据。
