Ayas Muhammet Salih, Kalkışım Muhammet, Turgut Mehmet Cenk, Dincer Recep, Aslan Oğuzhan, Öner Kerim, Köse Ahmet
Department of Orthopedics and Traumatology, Karadeniz Technical University, Trabzon, TUR.
Department of Orthopedics and Traumatology, Sorgun State Hospital, Yozgat, TUR.
Cureus. 2021 Dec 26;13(12):e20723. doi: 10.7759/cureus.20723. eCollection 2021 Dec.
Purpose We aimed to analyze the clinical and functional outcomes of patients who underwent surgery or received conservative treatment to look into the impact of treatment methods on clinical outcomes. Methods A retrospective study was performed on 25 patients with a minimum one-year follow-up. Patients were divided into two groups based on joint and physis displacement measured on preop CT images. Patients with a displacement of > 2 mm underwent surgery, while those with a displacement of < 2 mm received conservative treatment. The clinical results were assessed using the Ankle-Hindfoot Scale developed by the American Orthopedic Foot and Ankle Society (AOFAS) and the Modified Weber Protocol (MWP). Results The sample consisted of 14 patients who underwent surgery and 11 patients who received conservative treatment. The surgical group had a mean follow-up of 36.79±14.43 months, while the conservative group had a mean follow-up of 31.82±13.55 months. The surgical and conservative groups had a postop 1st-year AOFAS score of 96.64±3.54 and 93.64 ± 4.69, respectively. The difference was statistically insignificant (p > 0.05), but the surgical group had higher scores numerically. The surgical and conservative groups had a postop 6th-month AOFAS score of 84.64±1.64 and 80.82±2.85, respectively. The difference was statistically significant (p < 0.05). Conclusion The results of both surgical treatment and conservative treatment are satisfactory. Especially, surgical treatment should not be avoided in patients requiring surgery with a displacement of more than 2 mm and surgeons may consider surgery for better clinical outcomes and earlier rehabilitation in the treatment of triplane fractures.
目的 我们旨在分析接受手术或保守治疗的患者的临床和功能结局,以探讨治疗方法对临床结局的影响。方法 对25例患者进行回顾性研究,随访时间至少为1年。根据术前CT图像上测量的关节和骨骺移位情况将患者分为两组。移位>2 mm的患者接受手术治疗,而移位<2 mm的患者接受保守治疗。使用美国矫形足踝协会(AOFAS)制定的踝-后足评分量表和改良Weber方案(MWP)评估临床结果。结果 样本包括14例接受手术治疗的患者和11例接受保守治疗的患者。手术组的平均随访时间为36.79±14.43个月,而保守组的平均随访时间为31.82±13.55个月。手术组和保守组术后第1年的AOFAS评分分别为96.64±3.54和93.64±4.69。差异无统计学意义(p>0.05),但手术组的评分在数值上更高。手术组和保守组术后第6个月的AOFAS评分分别为84.64±1.64和80.82±2.85。差异有统计学意义(p<0.05)。结论 手术治疗和保守治疗的结果均令人满意。特别是,对于移位超过2 mm的需要手术的患者不应避免手术治疗,外科医生在治疗三平面骨折时可考虑手术以获得更好的临床结局和更早的康复。