Clinical Professor, School of Podiatric Medicine, University of Texas Rio Grande Valley, Harlingen, TX.
Associate Professor, Department of Biostatistics and Data Science, Department of Orthopaedic Surgery and Rehabilitaion, The University of Texas Medical Branch, Galveston, TX.
J Foot Ankle Surg. 2024 Jul-Aug;63(4):473-476. doi: 10.1053/j.jfas.2024.02.007. Epub 2024 Mar 2.
Rotational malleolar fractures result in a high prevalence of intra-articular pathologies; therefore, routine arthroscopic assessment may be beneficial in the surgical treatment of ankle fractures. However, the clinical studies regarding the effectiveness of arthroscopy thus far have mixed results. We investigated the efficacy of concurrent arthroscopy during the treatment of malleolar fractures using a large U.S. healthcare data set. Those who had arthroscopy were compared with those who did not, during the surgical treatment of malleolar fractures, while adjusting for covariates of clinical relevance. The analysis showed that concurrent arthroscopy is protective against postoperative repeat surgery (OR = 0.13, 95CI = 0.02-0.41) and wound dehiscence (OR = 0.18, 95CI = 0.03-0.56). The number of added arthroscopy cases needed to avoid one repeat surgery was 74, while that of wound dehiscence was 52. Further studies are needed to determine if routine use of arthroscopy is justifiable in the surgical treatment of malleolar fractures, given the additional costs and time to the healthcare system.
旋后外踝骨折常伴有踝关节内的病理改变，因此关节镜评估可能有益于踝关节骨折的手术治疗。然而，到目前为止，关于关节镜疗效的临床研究结果不一。我们使用美国大型医疗保健数据集研究了关节镜检查在治疗外踝骨折中的疗效。在调整与临床相关的协变量后，比较了关节镜检查与未行关节镜检查的外踝骨折患者的手术治疗效果。分析表明，关节镜检查可降低术后再次手术（OR = 0.13，95%CI = 0.02-0.41）和伤口裂开（OR = 0.18，95%CI = 0.03-0.56）的风险。为避免一次重复手术，需要增加的关节镜检查病例数为 74 例，而避免伤口裂开则需要 52 例。鉴于对医疗保健系统增加的成本和时间，还需要进一步的研究来确定在治疗外踝骨折时是否可以常规使用关节镜检查。
