Sidhu Sahil Prabhnoor, Atwan Yousif, Cavanagh Joseph, Sidhu Veer Sohail, Del Balso Christopher, Schemitsch Emil H, Sanders David W, Lawendy Abdel R
Department of Orthopaedic Surgery, Western University, London, ON, Canada.
J Orthop Trauma. 2022 Mar 1;36(3):152-156. doi: 10.1097/BOT.0000000000002237.
To investigate patient demographics, injury characteristics, radiographic outcomes, and identify risk factors for developing posttraumatic arthritis in high-energy transsyndesmotic ankle fracture dislocations or "logsplitter" injuries.
Retrospective cohort study.
Academic level one trauma center.
PATIENTS/PARTICIPANTS: Twenty-seven adult patients with logsplitter injuries.
All patients were treated with open reduction internal fixation, with possible addition of syndesmosis screw(s) and deltoid repair.
The rate of posttraumatic arthritis at one year along with rate and reasons for reoperation.
Twenty-seven patients were included with a mean follow-up of 14.5 ± 12.5 months. At one-year postoperative, 14 of the 20 patients (70%) demonstrated posttraumatic arthritis. Two patients (7.4%) went onto fusion. The reoperation rate was 51.9%. There was no significant difference in the arthritis rate with the number of syndesmosis screws used, quality of reduction, or addition of deltoid repair.
The logsplitter injury is one with devastating outcomes and high rates of arthritis; it should be considered separately from conventional ankle fractures. The role of deltoid repair remains unclear. Further study of this injury pattern is required.
Prognostic Level IV. See Instructions for Authors for a complete description of levels of evidence.
调查高能经下胫腓联合的踝关节骨折脱位或“劈木机”损伤患者的人口统计学特征、损伤特点、影像学结果，并确定创伤后关节炎发生的危险因素。
回顾性队列研究。
一级学术创伤中心。
患者/参与者：27例患有“劈木机”损伤的成年患者。
所有患者均接受切开复位内固定治疗，可能会加用下胫腓联合螺钉和三角韧带修复。
一年时创伤后关节炎的发生率以及再次手术的发生率和原因。
纳入27例患者，平均随访14.5±12.5个月。术后一年，20例患者中有14例（70%）出现创伤后关节炎。2例患者（7.4%）进行了关节融合。再次手术率为51.9%。使用下胫腓联合螺钉的数量、复位质量或三角韧带修复的加用与否，在关节炎发生率上无显著差异。
“劈木机”损伤预后严重，关节炎发生率高；应与传统踝关节骨折分开考虑。三角韧带修复的作用仍不明确。需要对这种损伤类型进行进一步研究。
预后IV级。有关证据水平的完整描述，请参阅作者须知。
