Department of Orthopaedics and Traumatology, Limmattal Hospital, Urdorferstrasse 100, Zurich-Schlieren, 8952, Switzerland.
Movemed, Department of Sport Medicine, University Hospital Balgrist, Zurich, 8008, Switzerland.
J Orthop Surg Res. 2024 Jun 2;19(1):327. doi: 10.1186/s13018-024-04820-x.
Ankle fractures are frequent, and despite numerous publications on their treatment and outcome, there is a lack of precise data on the functional results in young, healthy and physically active patients. We hypothesized that patients who underwent open reduction and internal fixation (ORIF) for simple ankle fractures would have similar function compared to a healthy control group, whereas patients with complex fractures will have significant functional deficits. Furthermore, we postulate that there is a discrepancy between the radiological and the functional outcomes.
A set of specific provocation tests was developed to evaluate the postoperative possibility of weight bearing, stop-and-go activities and range of motion. In combination with three questionnaires and a radiographic evaluation, the true functional outcome and the possibility of participating in sporting activities were investigated and compared with those of an age- and sex-matched control group.
A significant impairment was found in unilateral and simple ankle fractures. This impairment increased in tests including stop-and-go activities in combination with load bearing and with the complexity of the fractures. Concerning the subjective outcome, there was a significant adverse effect for daily activities without any difference in preoperative or postoperative sporting activity between the groups. No difference was found in the radiological assessment.
Both simple and complex ankle fractures treated with ORIF have a significant and long-lasting impact on functional outcome in young and active patients. The radiological result is not associated with a good functional outcome.
BASEC-Nr. 2018 - 01124.
踝关节骨折较为常见，尽管有大量关于其治疗和结果的出版物，但对于年轻、健康和活跃的患者的功能结果，仍缺乏精确的数据。我们假设接受切开复位内固定（ORIF）治疗的单纯踝关节骨折患者的功能与健康对照组相似，而复杂骨折患者则会存在明显的功能缺陷。此外，我们还假设影像学结果和功能结果之间存在差异。
设计了一组特定的激发试验，以评估术后负重、停走活动和关节活动度的可能性。结合三个问卷和影像学评估，对真实的功能结果和参与体育活动的可能性进行了调查，并与年龄和性别匹配的对照组进行了比较。
单侧和单纯踝关节骨折存在显著的功能障碍。在包括负重和骨折复杂性的停走活动的测试中，这种损伤会增加。在日常活动方面，主观结果存在显著的不良影响，但两组患者在术前或术后的体育活动方面没有差异。影像学评估没有差异。
接受 ORIF 治疗的单纯和复杂踝关节骨折都会对年轻、活跃患者的功能结果产生显著且持久的影响。影像学结果与良好的功能结果无关。
BASEC-Nr. 2018 - 01124。
