Zenker H, Nerlich M
Arch Orthop Trauma Surg (1978). 1982;100(4):237-41. doi: 10.1007/BF00381663.
A long-term follow-up (3.5 years mean) of 106 operated ankle fractures out of 167 patients revealed 73.7% excellent and good, 16% acceptable and 10.3% poor results. Anatomically exact reduction was shown to be a prerequisite for good results and was seen in 77.2% of all cases. By neglecting biomechanical principles an insufficient reconstruction led to a poor final outcome. But even in 11% of the excellent operatively treated fractures late arthrosis developed. Statistical analysis showed that the onset of posttraumatic arthrosis was correlated with and predicted best by the number of single lesions. Dorsiflexion testing was the clinical parameter correlating best with the extent of the injury, the degree of arthrosis and the subjective complaints. This underlines the importance of assessment of dorsiflexion as a clinical screening test for remaining sequelae after ankle fractures.
对167例患者中106例接受手术治疗的踝关节骨折进行长期随访（平均3.5年），结果显示优良率为73.7%，可接受率为16%，差的结果为10.3%。解剖学精确复位被证明是取得良好结果的前提条件，在所有病例中有77.2%实现了精确复位。由于忽视生物力学原理，重建不足导致最终结果不佳。但即使在手术治疗效果优良的骨折中，仍有11%出现了晚期关节炎。统计分析表明，创伤后关节炎的发生与单一损伤的数量相关，且单一损伤数量对其预测效果最佳。背屈试验是与损伤程度、关节炎程度和主观症状相关性最好的临床参数。这强调了将背屈评估作为踝关节骨折后残留后遗症临床筛查试验的重要性。
