Department of Orthopaedics, The Third Hospital of Hebei Medical University, Shijiazhuang, China.
Orthop Surg. 2024 May;16(5):1230-1238. doi: 10.1111/os.14047. Epub 2024 Mar 31.
Unstable trimalleolar fractures are relatively complex and more difficult to manage if die-punch fracture is present. We aimed to evaluate the curative effect of homeopathic ankle dislocation on the unstable trimalleolar fractures involving posterior die-punch fragments.
A total of 124 patients diagnosed with unstable trimalleolar fractures combined with post-die punch fragment between June 2008 and June 2020 were retrospectively included. Patients who received homeopathic ankle dislocation were named as the experimental group, and patients who accepted conventional treatment were control group. The fracture healing time, wound healing, American Orthopedic Foot and Ankle Society ankle-hindfoot scale (AOFAS), visual analogue scale (VAS), the Kellgren-Lawrence arthritis grading scale (KLAGS) and short-form 36 score (SF-36) scores were collected. Student t-test was used for fracture healing time. Wound healing and SF-36 were compared using the Mann-Whitney test. Repeated measurement analysis of variance (ANOVA) was used for AOFAS and VAS. χ-test was used for KLAGS.
AOFAS showed statistically significant differences between the two groups (p = 0.001). In non-weight-bearing and weight-bearing conditions, VAS scores were significant different between the two groups, and there was an interaction between group and time point (p < 0.001). The experimental group was superior to the control group in terms of physical function (p = 0.022), role-physical (p = 0.018), general health (p = 0.001) and social function (p = 0.042).The operation time of experimental group was shorter than that of control group (p < 0.001).
Homeopathic ankle dislocation is used for the unstable trimalleolar fractures involving posterior die-punch fragment, which can provide better functional outcomes while shortening the operation time and recovery period.
如果存在蝶形骨折,不稳定的三踝骨折则相对复杂,处理起来也更为困难。我们旨在评估手法复位踝关节脱位治疗涉及后蝶形骨折块的不稳定三踝骨折的疗效。
回顾性纳入 2008 年 6 月至 2020 年 6 月期间诊断为不稳定三踝骨折合并后蝶形骨折块的 124 例患者。接受手法复位踝关节脱位治疗的患者为实验组,接受常规治疗的患者为对照组。收集骨折愈合时间、伤口愈合情况、美国矫形足踝协会踝-后足评分(AOFAS)、视觉模拟评分(VAS)、Kellgren-Lawrence 关节炎分级量表(KLAGS)和简明健康状况调查量表 36 项(SF-36)评分。采用 Student t 检验比较骨折愈合时间,采用 Mann-Whitney 检验比较伤口愈合和 SF-36 评分,采用重复测量方差分析(ANOVA)比较 AOFAS 和 VAS 评分,采用 χ²检验比较 KLAGS 评分。
AOFAS 评分两组间差异有统计学意义(p = 0.001)。非负重位和负重位时,两组间 VAS 评分差异有统计学意义,且组间和时间点间存在交互作用(p < 0.001)。实验组在生理功能(p = 0.022)、躯体角色功能(p = 0.018)、总体健康(p = 0.001)和社会功能(p = 0.042)方面优于对照组。实验组的手术时间短于对照组(p < 0.001)。
手法复位踝关节脱位治疗涉及后蝶形骨折块的不稳定三踝骨折,可以提供更好的功能结果,同时缩短手术时间和恢复时间。