关节联合柔性固定治疗关节联合损伤伴踝关节骨折的临床疗效。

IF 2.4 2区 医学 Q2 ORTHOPEDICS
Foot & Ankle International Pub Date : 2023-11-01 Epub Date: 2023-09-07 DOI:10.1177/10711007231194045
Sung Hwan Kim, Sang Heon Lee, Young Koo Lee
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引用次数: 0

摘要

背景:我们评估关节联合复位的质量是否会影响踝关节旋转骨折患者灵活固定的短期临床结果。方法:本研究纳入59例患者(男32例,女27例)。通过术后3天内获得的计算机断层扫描(CT)图像评估关节综合征减轻程度。我们测量了胫骨远端关节关节上方1cm处前后切牙间的散度,然后评估腓骨相对于胫骨的旋转程度。术后1年,采用美国骨科足踝协会(AOFAS)评分、视觉模拟评分(VAS)和足踝预后评分(FAOS)进行客观临床评价。此外,术后近1年,在常规取出植入物时进行重复关节镜检查。结果:59例经关节联合柔性固定的患者中,56例经重复关节镜检查具有关节联合稳定性。术后1年,准确复位组(n = 24)的AOFAS、VAS和FAOS评分分别为90、2.0和94分,不良复位组(n = 35)的AOFAS、VAS和FAOS评分分别为90、1.0和94.5分。结论:经术后早期CT影像学检查,关节联合损伤柔性固定复位质量不影响患者预后。在本队列中,韧带联合复位和灵活固定可能对韧带联合损伤和踝关节骨折患者产生良好的临床效果。证据等级:III级,回顾性队列研究。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The Clinical Outcomes of Syndesmotic Flexible Fixation for Syndesmotic Injury With Ankle Fracture.

Background: We evaluated whether the quality of syndesmotic reduction affects the short-term clinical outcomes of flexible fixation in patients with a rotational ankle fracture.

Methods: This study included 59 patients (32 men and 27 women) who underwent syndesmotic flexible fixation. The degree of syndesmotic reduction was evaluated on computed tomography (CT) images acquired within 3 days after surgery. We measured the divergence between anterior and posterior incisura at 1 cm above the distal tibial articular joint, then evaluated the degree of fibular rotation relative to the tibia. At 1 year after surgery, an objective clinical evaluation was performed using the American Orthopaedic Foot & Ankle Society (AOFAS) score, the visual analog scale (VAS), and the Foot and Ankle Outcome Score (FAOS). Additionally, repeat arthroscopy was performed during routine implant removal at nearly 1 year postoperatively.

Results: Among 59 patients who underwent syndesmotic flexible fixation, 56 patients had syndesmotic stability on repeat arthroscopy. At 1 year postoperation, AOFAS, VAS, and FAOS scores were, respectively, 90, 2.0, and 94 in the accurate reduction group (n = 24) and 90, 1.0, and 94.5 in the malreduction group (n = 35).

Conclusion: Reduction quality after syndesmotic injury with flexible fixation, as determined by early postoperative CT imaging, did not affect patient prognosis. In this cohort, syndesmotic reduction and flexible fixation may produce good clinical outcomes in patients with syndesmotic injury and ankle fracture.

Level of evidence: Level III, retrospective cohort study.

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来源期刊
Foot & Ankle International
Foot & Ankle International 医学-整形外科
CiteScore
5.60
自引率
22.20%
发文量
144
审稿时长
2 months
期刊介绍: Foot & Ankle International (FAI), in publication since 1980, is the official journal of the American Orthopaedic Foot & Ankle Society (AOFAS). This monthly medical journal emphasizes surgical and medical management as it relates to the foot and ankle with a specific focus on reconstructive, trauma, and sports-related conditions utilizing the latest technological advances. FAI offers original, clinically oriented, peer-reviewed research articles presenting new approaches to foot and ankle pathology and treatment, current case reviews, and technique tips addressing the management of complex problems. This journal is an ideal resource for highly-trained orthopaedic foot and ankle specialists and allied health care providers. The journal’s Founding Editor, Melvin H. Jahss, MD (deceased), served from 1980-1988. He was followed by Kenneth A. Johnson, MD (deceased) from 1988-1993; Lowell D. Lutter, MD (deceased) from 1993-2004; and E. Greer Richardson, MD from 2005-2007. David B. Thordarson, MD, assumed the role of Editor-in-Chief in 2008. The journal focuses on the following areas of interest: • Surgery • Wound care • Bone healing • Pain management • In-office orthotic systems • Diabetes • Sports medicine
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