Advancing treatment strategies for posterior malleolar malunion: The ankle dislocation method.

IF 1.9 3区医学 Q2 ORTHOPEDICS

Foot and Ankle Surgery Pub Date : 2024-05-22 DOI:10.1016/j.fas.2024.05.009

Guo-Dong Shen, Wen-Bo Bai, Bao-Li Zou, Zhi-Bin Lai, Kang-Yong Yang, Hong-Ning Zhang, Zhi-Qiang Xu, Yong-Zhan Zhu

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引用次数: 0

Abstract

Background: This study aimed to assess the radiological and clinical outcomes of treatment using the ankle dislocation method for posterior malleolar malunion.

Method: Thirty-one patients with posterior malleolar malunion who underwent treatment using the ankle dislocation method from May 2015 to October 2021 were retrospectively analyzed. Key outcome measures were radiographic parameters (articular step-off, tibiofibular clear space, fibular length, tibial lateral surface angle, and ankle osteoarthritis), clinical scores (American Orthopaedic Foot and Ankle Society ankle-hindfoot scale and Visual Analogue Scale), and patient satisfaction rate.

Result: Preoperative computed tomography revealed that Bartoní ček types 3 and 4 accounted for 64.5 % (n = 20) of total cases. Most posterior malleolar malunions were accompanied by depressed intercalary fragments (61.2 % [n = 19]). At the final follow-up, radiographic parameters and clinical scores showed significant improvements postoperatively (P < 0.05), with a high patient satisfaction rate of 77.4 %. Subgroup analysis revealed that the posterior malleolar fracture morphology significantly affected postoperative pain, particularly in more complex fractures (P < 0.001).

Conclusion: The ankle dislocation method effectively exposes the distal tibial articular surface and facilitates the anatomical restoration of joint congruity under direct vision. This approach substantially improves the clinical and imaging outcomes in patients with complex posterior malleolar malunion.

Levels of evidence: Level IV, retrospective case series.

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推进踝关节后错位的治疗策略：踝关节脱位法

背景：本研究旨在评估使用踝关节脱位法治疗踝关节后错位的放射学和临床效果：本研究旨在评估踝关节脱位法治疗后踝骨发育不良的放射学和临床效果：回顾性分析2015年5月至2021年10月期间接受踝关节脱位法治疗的31例踝后错位患者。主要结果指标为影像学参数（关节台阶、胫腓间隙、腓骨长度、胫骨外侧面角和踝关节骨关节炎）、临床评分（美国骨科足踝协会踝-后足量表和视觉模拟量表）和患者满意率：术前计算机断层扫描显示，Bartoní ček 3型和4型占总病例的64.5%（n = 20）。大多数臼后畸形伴有凹陷的闰骨碎片（61.2% [n = 19]）。在最后的随访中，放射学参数和临床评分在术后均有明显改善（P 结论：踝关节脱位法能有效改善踝关节的功能：踝关节脱位法能有效暴露胫骨远端关节面，有助于在直视下从解剖学角度恢复关节的一致性。这种方法大大改善了复杂后踝关节错位患者的临床和影像学效果：IV级，回顾性病例系列。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Foot and Ankle Surgery ORTHOPEDICS-

CiteScore

4.60

自引率

16.00%

发文量

202

期刊介绍： Foot and Ankle Surgery is essential reading for everyone interested in the foot and ankle and its disorders. The approach is broad and includes all aspects of the subject from basic science to clinical management. Problems of both children and adults are included, as is trauma and chronic disease. Foot and Ankle Surgery is the official journal of European Foot and Ankle Society. The aims of this journal are to promote the art and science of ankle and foot surgery, to publish peer-reviewed research articles, to provide regular reviews by acknowledged experts on common problems, and to provide a forum for discussion with letters to the Editors. Reviews of books are also published. Papers are invited for possible publication in Foot and Ankle Surgery on the understanding that the material has not been published elsewhere or accepted for publication in another journal and does not infringe prior copyright.