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预测稳定旋后外旋型 2 型踝关节骨折更好结局的因素。

Predicting factors for better outcomes of stable supination external rotation type 2 ankle fractures.

机构信息

Brighton & Sussex University Hospitals, NHS Trust, Brighton, BN2 5BE, United Kingdom.

Brighton & Sussex University Hospitals, NHS Trust, Brighton, BN2 5BE, United Kingdom.

出版信息

Chin J Traumatol. 2022 Nov;25(6):353-356. doi: 10.1016/j.cjtee.2022.06.005. Epub 2022 Jun 22.

Abstract

PURPOSE

Stable Weber B ankle fractures are treated by a walking boot for 6 weeks and bearing full weight through the boot as tolerated. The aim of the present study was to assess the outcome parameters of this treatment protocol, evaluate the efficacy of using the walking boot, and investigate any possible predicting factors that could affect the outcomes.

METHODS

All the patients with stable Weber B ankle fractures, treated in our hospital between January 2018 and December 2018, were prospectively included to the study. The patients were evaluated clinically, and the patient-reported outcome measures data were collected at the 2 and 6 weeks post-injury. Chi square, Spearman's rho test, independent samples and paired sample t-tests were used for the monovariant analysis.

RESULTS

A total of 128 consecutive patients (aged 52.2 ± 19.1 years) with supination external rotation type 2 fracture were finally included to the study. At the 2 weeks follow-up, the reported outcome measures scores were in moderate levels, but improved significantly at the 6 weeks follow-up (p < 0.0001). Multivariant analysis revealed that the ability to bear full weight without the boot at the 2 weeks after diagnosis was the only variable, which made statistically unique contribution to the foot and ankle disability index score at the 6 weeks (p = 0.005).

CONCLUSION

Conservative treatment using a walking boot with advice to bear full weight of stable ankle Weber B fractures can bring to good functional outcomes. The ability to bear full weight without the aid of the walking boot at 2 weeks after diagnosis was the only significant predicting factor for better outcomes at 6 weeks after diagnosis.

摘要

目的

稳定型 Weber B 踝关节骨折采用步行靴治疗 6 周,在耐受范围内通过靴子完全负重。本研究旨在评估该治疗方案的结果参数,评估步行靴的疗效,并研究任何可能影响结果的预测因素。

方法

2018 年 1 月至 2018 年 12 月期间,我院前瞻性纳入所有稳定型 Weber B 踝关节骨折患者。对患者进行临床评估,并在受伤后 2 周和 6 周收集患者报告的结果测量数据。采用卡方检验、斯皮尔曼 rho 检验、独立样本和配对样本 t 检验进行单变量分析。

结果

共有 128 例连续患者(年龄 52.2 ± 19.1 岁)最终纳入本研究。在 2 周随访时,报告的结果测量评分处于中等水平,但在 6 周随访时显著改善(p < 0.0001)。多变量分析显示,在诊断后 2 周内能够不借助靴子完全负重是唯一对足部和踝关节残疾指数评分在 6 周时具有统计学意义的变量(p = 0.005)。

结论

对于稳定型 Weber B 踝关节骨折,使用步行靴进行保守治疗并建议完全负重可获得良好的功能结果。在诊断后 2 周内无需借助步行靴即可完全负重是诊断后 6 周时获得更好结果的唯一显著预测因素。

相似文献

本文引用的文献

2
Stability in ankle fractures: Diagnosis and treatment.踝关节骨折的稳定性:诊断与治疗。
EFORT Open Rev. 2018 May 21;3(5):294-303. doi: 10.1302/2058-5241.3.170057. eCollection 2018 May.
8
Supination-external rotation ankle fractures: stability a key issue.旋后-外旋型踝关节骨折:稳定性是关键。
Clin Orthop Relat Res. 2010 Jan;468(1):243-51. doi: 10.1007/s11999-009-0988-2. Epub 2009 Jul 18.
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Conservative functional treatment of ankle fractures.踝关节骨折的保守功能治疗
Arch Orthop Trauma Surg. 2002 Apr;122(3):165-8. doi: 10.1007/s004020100342. Epub 2001 Oct 9.

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