Contemporary Long-Term Patient Reported Outcomes of Pilon Fractures.

IF 1.5 4区 医学 Q3 SURGERY
Thomas J Ryan, Natalie Enninghorst, Jessica Partridge, Ahmed Sulemain, Jacqueline Du Plessis, Chris Henry, Natasha Weaver, Seth M Tarrant, Zsolt J Balogh
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引用次数: 0

Abstract

Background: Pilon fractures are historically associated with suboptimal outcomes. No long-term Australian data is available on patient-reported outcomes. We hypothesised that pilon fracture long-term outcomes are inferior to Australian population norms.

Methods: A 14-year retrospective study was conducted in a Level-1 trauma centre on AO/OTA type-B/C fractures. Type-A fractures, skeletally immature, interpreter requirement and primary amputation were excluded. Demographics, injury characteristics, management and complications were collected. The primary outcome was SF-36 with adjusted Australian norms.

Results: From 127 eligible patients, 73 were included in the study (age: 46 ± 17 years; 50 [69%] males) with 8.7 ± 3.9 years follow-up. Management included ORIF 46 (61%), external fixation (EF) with staged ORIF 17 (23%), definitive EF 4 (5%) and 8 (11%) non-operative. Further surgical intervention was required in 25 (34%) patients, with the majority for hardware removal (14 [19%]). Compared with Australian SF-36 norms, the mean Physical Component Score was lower (44.7 ± 8.9 vs. 50.3, p ≤ 0.001) whereas the Mental Component Score (51.2 ± 12.5 vs. 51.2, p = 0.24) was not. Median return to work was 4.5 months (IQR 5), with 47 (87%) of the 54 employed pre-injury working at 12 months. Two (3.7%) patients did not return to work and 24 (44%) returned at a reduced capacity.

Conclusion: This study provides a contemporary reference for pilon fractures managed in Australia. Outcomes were favourable when compared internationally. These patients are likely to resume employment, often at reduced capacity, while experiencing moderate long-term impacts to their physical well-being due to persistent pain.

当代长期患者报告的皮隆骨折预后。
背景:皮隆骨折历来与次优预后相关。澳大利亚没有关于患者报告结果的长期数据。我们假设枕部骨折的长期预后低于澳大利亚人群的标准。方法:在一家一级创伤中心对AO/OTA型b /C型骨折进行了为期14年的回顾性研究。排除a型骨折、骨骼不成熟、需要翻译和初次截肢。收集人口统计学、损伤特征、处理和并发症。主要结果为SF-36,符合调整后的澳大利亚标准。结果:127例符合条件的患者中,73例纳入研究(年龄:46±17岁;50例(69%)男性),随访8.7±3.9年。治疗包括ORIF 46例(61%),分阶段ORIF的外固定(EF) 17例(23%),最终EF 4例(5%)和非手术8例(11%)。25例(34%)患者需要进一步手术干预,其中大多数为硬体取出(14例[19%])。与澳大利亚SF-36标准比较,体格成分得分(44.7±8.9比50.3,p≤0.001)低于心理成分得分(51.2±12.5比51.2,p = 0.24)。恢复工作的中位数为4.5个月(IQR 5), 54名受聘人员中有47名(87%)在受伤前工作了12个月。2名(3.7%)患者没有返回工作岗位,24名(44%)患者返回工作岗位。结论:本研究为澳大利亚枕部骨折的治疗提供了当代参考。在国际上比较,结果是有利的。这些患者很可能恢复工作,通常是在能力下降的情况下,同时由于持续的疼痛对他们的身体健康造成中度的长期影响。
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
ANZ Journal of Surgery
ANZ Journal of Surgery 医学-外科
CiteScore
2.50
自引率
11.80%
发文量
720
审稿时长
2 months
期刊介绍: ANZ Journal of Surgery is published by Wiley on behalf of the Royal Australasian College of Surgeons to provide a medium for the publication of peer-reviewed original contributions related to clinical practice and/or research in all fields of surgery and related disciplines. It also provides a programme of continuing education for surgeons. All articles are peer-reviewed by at least two researchers expert in the field of the submitted paper.
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