Department of Orthopaedics, Faculty of Medicine, the University of British Columbia, Vancouver, BC, Canada ; and.
Division of Orthopaedic Trauma, Vancouver General Hospital, Vancouver Coastal Health, Vancouver, BC, Canada .
J Orthop Trauma. 2022 Jun 1;36(6):e250-e254. doi: 10.1097/BOT.0000000000002312.
To describe the trajectory of recovery following fixation of pilon fractures from baseline to 5-year follow-up.
Prospective cohort study.
Level-1 trauma center.
PATIENTS/PARTICIPANTS: Patients with pilon fractures (OTA/AO 43.C) treated with open reduction and internal fixation.
None.
Patient-reported outcome measures were measured at baseline, 6 months, 1 year, and 5 years using the Short-Form 36 Health Survey (SF-36) Physical Component Score and Mental Component Score, Short Musculoskeletal Functional Assessment, and the Foot and Ankle Outcome Score.
One hundred two patients were enrolled: mean age was 42.6 years; 69% were males; 88% had an injury severity score of 9; 74 patients (73%) completed 1-year follow-up; 40 patients (39%) completed 5-year follow-up. Trajectory of recovery of physical function showed a significant decline between baseline and 6 months, with significant improvement between 6 months and 1 year and then ongoing but slower improvement between 1 year and 5 years. Sixty-four patients returned to baseline SF-36 Physical Component Score at 5 years. Pain was a persistent issue and remained significantly worse at 5 years when compared with baseline. Psychological well-being (SF-36 Mental Component Score) did not significantly change from baseline at 5 years.
Functional recovery following open reduction and internal fixation for pilon fractures was characterized by an initial decrease in function from baseline, followed by an increase between 6 months and 1 year, and then slower but continued increases from 1 year to 5 years. Function did not return to baseline levels, pain was a persistent issue, and mental well-being showed no change from baseline at 5 years. This information may be useful when counselling patients.
Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
描述从基线到 5 年随访期间 Pilon 骨折固定后的恢复轨迹。
前瞻性队列研究。
1 级创伤中心。
患者/参与者：接受切开复位内固定治疗的 Pilon 骨折患者（OTA/AO 43.C）。
无。
在基线、6 个月、1 年和 5 年时使用简明 36 健康调查（SF-36）生理成分评分和心理成分评分、短肢肌肉骨骼功能评估和足踝结局评分测量患者报告的结果测量值。
共纳入 102 例患者：平均年龄 42.6 岁；69%为男性；88%的损伤严重程度评分（ISS）为 9 分；74 例（73%）患者完成 1 年随访；40 例（39%）患者完成 5 年随访。生理功能的恢复轨迹在基线至 6 个月之间明显下降，在 6 个月至 1 年之间显著改善，然后持续改善，但在 1 年至 5 年之间改善速度较慢。64 例患者在 5 年时恢复到基线 SF-36 生理成分评分。疼痛是一个持续存在的问题，与基线相比，在 5 年时仍明显更严重。心理幸福感（SF-36 心理成分评分）在 5 年内与基线相比没有显著变化。
切开复位内固定治疗 Pilon 骨折后的功能恢复表现为从基线开始功能下降，然后在 6 个月至 1 年之间增加，然后从 1 年到 5 年之间逐渐增加但速度较慢。功能未恢复到基线水平，疼痛是一个持续存在的问题，5 年内心理幸福感与基线相比没有变化。这些信息在为患者提供咨询时可能有用。
治疗性 IV 级。有关证据水平的完整描述，请参阅作者说明。
