Post-traumatic osteoarthritis after ankle fracture fixation: A minimum three-year follow-up.

IF 1.9 3区医学 Q2 ORTHOPEDICS

Foot and Ankle Surgery Pub Date : 2025-02-26 DOI:10.1016/j.fas.2025.02.014

Lin Wang, Chenni Ji, Xuesong Zhang, Lingchan Wang, Tianwei Liu, Huixian Sun, Yaming Zhang

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引用次数: 0

Abstract

Purpose: Post-traumatic osteoarthritis (PTOA) is a prevalent and serious complication after ankle fracture surgery, and due to its delayed nature and nonspecific symptoms, identifying the risk factors is highly cost-effective. The aim of this study is to investigate the incidence and risk factors associated with PTOA following ankle fracture surgery.

Methods: This study retrospectively analyzed patients who presented with ankle fractures and underwent open reduction and internal fixation (ORIF) at a university-affiliated tertiary care facility, between January 2018 and October 2021. Patients included must have complete data and a minimum 3-year follow-up assessments. Radiographic PTOA was diagnosed and classified in accordance with a validated and widely used criteria. Twenty-two potential risk factors selected based on literature, univariate statistical analysis and biologic plausibility were included for analysis. Univariate analysis and multivariable regression model were used to identify the independent risk factors.

Results: A total of 477 eligible patients were included, comprising 279 males and 198 females, with a mean age of 49.0 ± 9.5 years, and the mean follow-up was 4.3 years. Radiographic PTOA was present in 163 patients (34.2 %), classified as grade Ⅰ in 96 (20.1), grade Ⅱ in 47 (9.9 %), and grade Ⅲ in 20 patients (4.2 %), respectively. Five risk factors were identified, including age (≥ 60 years) (OR, 1.416; 95 %CI, 1.122-2.161), physical labor intensity (> II) (OR, 2.997; 95 % CI, 1.791-5.015), BMI ≥ 28 kg/m² (OR, 2.186; 95 % CI, 1.067-4.112), posterior malleolus and involvement of the articular surface (≤ 25 %: OR, 2.024; 95 % CI, 1.167-3.511; > 25 %: OR, 3.533; 95 % CI, 1.630-67.658), and postoperative articular incongruency (OR, 2.011; 95 % CI, 1.138-4.058).

Conclusions: These findings enhance the understanding of its risk profile, and may inform clinical decision-making and guide targeted interventions to mitigate the risk in vulnerable populations.

查看原文本刊更多论文

踝关节骨折固定后创伤性骨关节炎：至少三年随访。

目的：创伤后骨关节炎（PTOA）是踝关节骨折术后常见且严重的并发症，由于其迟发性和非特异性症状，识别危险因素具有很高的成本效益。本研究的目的是探讨踝关节骨折术后上睑下垂的发生率及相关危险因素。方法：本研究回顾性分析了2018年1月至2021年10月期间在大学附属三级医疗机构接受切开复位内固定（ORIF）治疗的踝关节骨折患者。纳入的患者必须有完整的数据和至少3年的随访评估。影像学诊断和分类是根据一个有效的和广泛使用的标准。根据文献、单变量统计分析和生物学似然性筛选出22个潜在危险因素进行分析。采用单因素分析和多变量回归模型确定独立危险因素。结果：共纳入477例符合条件的患者，其中男性279例，女性198例，平均年龄49.0 ± 9.5岁，平均随访时间4.3年。163例患者（34.2% %）存在放射学上睑下垂，分别为Ⅰ级96例（20.1%），Ⅱ级47例（9.9 %），Ⅲ级20例（4.2 %）。确定了5个危险因素，包括年龄（≥60岁）(OR, 1.416；95 %CI, 1.122-2.161)，体力劳动强度（> II） (OR, 2.997；95 % CI, 1.791 - -5.015), BMI≥ 28 kg / m2 (OR, 2.186;95 % CI, 1.067-4.112)，后踝和关节面受累(≤25 %:OR, 2.024；95 % ci, 1.167-3.511；> 25 %：或，3.533；95 % CI, 1.630-67.658)和术后关节不一致(OR, 2.011；95 % ci, 1.138-4.058)。结论：这些发现增强了对其风险概况的理解，并可能为临床决策提供信息，并指导有针对性的干预措施，以减轻弱势群体的风险。

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.