Department of Orthopaedic Surgery and Traumatology, Fribourg Cantonal Hospital, University of Fribourg, Chemin Des Pensionnats 2-6, 1708, Fribourg, Switzerland.
Department of Orthopaedic Surgery and Traumatology, Valais Hospital, Martiny, Switzerland.
Eur J Orthop Surg Traumatol. 2024 Nov 26;35(1):28. doi: 10.1007/s00590-024-04153-9.
Malleolar fractures are the most common ankle fractures and a major risk factor for ankle osteoarthritis in the long-term. Little is known about modifiable risk factors for a satisfactory outcome. This study aimed to assess the long-term clinical, functional and radiological outcomes in patients after osteosynthesis.
In this retrospective single center study, we assessed the difference in patients who underwent surgical intervention for malleolar fractures sustained between 2007 and 2014. The reduction was assessed on the first postoperative radiograph. At follow-up patients completed a questionnaire, including the European Foot and Ankle Society (EFAS) and Short Form-12 (SF-12) scores to evaluate patient-reported outcomes and quality of life. Ankle osteoarthritis was assessed using the Kellgren and Lawrence classification.
One hundred seventeen patients, 102 with anatomic reduction and 15 with malreduction, were reached at mean follow-up at 11.4 years and 10.9 years. The mean EFAS score was 18,0 for anatomic and 16,1 for nonanatomic reduction and 6.1 and 4.5 for the sport component. The rate of satisfaction with the result was 8.2 in anatomic reduction and 7.5 in the malreduction. There was no significant difference in the SF-12 group between the two groups. Anatomic reduction is a protective facture for a satisfactory outcome in the univariate model with the hazard ratio of 5.94.
Anatomic reduction is one of the strongest protective factors for satisfactory outcome after malleolar fractures in a follow-up of more than 10 years.
踝部骨折是最常见的踝关节骨折，也是长期踝关节骨关节炎的主要危险因素。对于可改变的预后良好的危险因素知之甚少。本研究旨在评估接受内固定治疗后的患者的长期临床、功能和影像学结果。
在这项回顾性单中心研究中，我们评估了 2007 年至 2014 年期间接受手术治疗的踝部骨折患者之间的差异。术后首次 X 线片评估复位情况。在随访中，患者完成了一份问卷，包括欧洲足部和踝关节协会（EFAS）和简化 12 项健康调查量表（SF-12）评分，以评估患者报告的结果和生活质量。使用 Kellgren 和 Lawrence 分类评估踝关节骨关节炎。
117 例患者，102 例解剖复位，15 例复位不良，平均随访 11.4 年和 10.9 年。解剖复位的平均 EFAS 评分为 18.0，非解剖复位为 16.1；运动部分分别为 6.1 和 4.5。解剖复位的满意度为 8.2%，非解剖复位为 7.5%。两组间 SF-12 组无显著性差异。在单变量模型中，解剖复位是良好预后的保护因素，风险比为 5.94。
在超过 10 年的随访中，解剖复位是踝部骨折后预后良好的最强保护因素之一。
