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运动员不稳定型Lisfranc损伤手术治疗后的患者报告结局指标

Patient-Reported Outcome Measures After Surgical Management of Unstable Lisfranc Injuries in Athletes.

作者信息

Brown Cortez L, James Nia A, Onyeukwu Chukwudi, Belayneh Rebekah, Boakye Lorraine, Hogan MaCalus V

机构信息

Department of Orthopaedic Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.

出版信息

Foot Ankle Orthop. 2023 Mar 20;8(1):24730114231160762. doi: 10.1177/24730114231160762. eCollection 2023 Jan.

Abstract

BACKGROUND

Athletes sustaining Lisfranc joint instability after a low-energy injury often undergo surgical fixation. Limited studies report validated patient-reported outcome measures (PROMs) for this specific patient population. Our purpose was to report PROMs of athletes experiencing instability after a low-energy Lisfranc injury and undergoing surgical fixation.

METHODS

Twenty-nine athletes (23 competitive, 6 recreational) sustained an unstable Lisfranc injury (14 acute, 15 chronic) and met our inclusion criteria. Injuries were classified as acute if surgically managed within 6 weeks. All athletes completed validated PROMs pre- and postoperatively. The cohort underwent various open reduction internal fixation methods. We evaluated outcomes with the Foot and Ankle Ability Measure (FAAM) activities of daily living (ADL) and sports subscales.

RESULTS

Fourteen of 29 (48%) athletes reported PROMs at ≥2 years with a median follow-up time of 44.5 months. Substantial improvement for both FAAM ADL (50% vs 93%;  < .001) and sports (14.1% vs 80%;  = .002) subscales were found, when comparing preoperative to postoperative scores at ≥2 years.

CONCLUSION

This study provides outcomes information for the young athletic population that were treated operatively for low-energy Lisfranc injury with apparent joint instability. Based on the FAAM sports subscale, these patients on average improved between their 6-month evaluation and their final ≥2 years but still scored 80% of the possible 100%, which indicates continued but "slight" difficulty with lower extremity function.

LEVEL OF EVIDENCE

Level IV, case series.

摘要

背景

低能量损伤后发生Lisfranc关节不稳的运动员常接受手术固定治疗。针对这一特定患者群体,仅有有限的研究报告了经过验证的患者报告结局指标(PROMs)。我们的目的是报告低能量Lisfranc损伤后出现不稳并接受手术固定的运动员的PROMs。

方法

29名运动员(23名竞技运动员,6名业余运动员)发生了不稳定的Lisfranc损伤(14例急性损伤,15例慢性损伤),并符合我们的纳入标准。如果在6周内进行手术治疗,则损伤被分类为急性损伤。所有运动员在术前和术后均完成了经过验证的PROMs。该队列采用了各种切开复位内固定方法。我们使用足踝能力测量(FAAM)日常生活活动(ADL)和运动亚量表评估结局。

结果

29名运动员中有14名(48%)在≥2年时报告了PROMs,中位随访时间为44.5个月。与≥2年时的术前评分相比,FAAM ADL亚量表(50%对93%;P<0.001)和运动亚量表(14.1%对80%;P=0.002)均有显著改善。

结论

本研究为因低能量Lisfranc损伤伴明显关节不稳而接受手术治疗的年轻运动员群体提供了结局信息。根据FAAM运动亚量表,这些患者在6个月评估至最终≥2年期间平均有所改善,但仍获得了可能的100分中的80分,这表明下肢功能仍持续存在但“轻微”困难。

证据级别

IV级,病例系列。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3718/10031611/10d8c118dd9e/10.1177_24730114231160762-fig1.jpg

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