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.

Abstract Image

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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