影响皮隆变异性后外踝骨折预后的因素:回顾性研究。

IF 1.3 4区 医学 Q2 Medicine
Yun Gao, Yihao Sun, Zhijun Shen, Jinliang Xie, Cheng Chen, Jian Hu, Lei Wang
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引用次数: 0

摘要

Pilon变异性后踝骨折复位质量差可能导致关节不协调,导致功能损伤和最终的创伤后关节炎。尽管在PVPM骨折中经常观察到关节内撞击碎片(IAIF),但临床对IAIF复位的必要性仍存在争议,并且IAIF存在或复位不良的预后意义尚不清楚。本回顾性研究对64例手术治疗的PVPM骨折的预后因素进行了24个月的随访。根据复位质量对患者进行分组。术后关节步进和/或分离≥2mm被认为复位“不良”,否则为“最佳或良好”。AOFAS是主要结局,VAS疼痛评分、医学结局研究36项简短健康调查(SF-36)是次要结局。AOFAS、SF-36、VAS在复位质量组间比较有统计学差异,最佳复位效果在术后24个月明显较好。两性别间AOFAS、SF-36、VAS评分也有统计学差异,女性患者预后明显较差。IAIF的存在、大小、形态差异和位置均不影响预后。通过线性回归分析,“女性”、“复位不良”和“关节联合固定”是影响PVPM骨折术后24个月功能预后的分类变量。本研究表明,基于关节步进分离的复位质量与PVPM骨折术后24个月的临床结果呈正相关,与IAIF无关。因此,无论是否存在IAIF,关节整合度的复位质量对PVPM骨折的预后均有积极影响。证据等级:3。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Factors for the prognosis of pilon variant posterior malleolar fracture: A retrospective study.

Poor reduction quality in Pilon variant posterior malleolar (PVPM) fractures may lead to articular incongruity, resulting in functional impairment and eventual post-traumatic arthritis. Although intra-articular impacted fragments (IAIF) are frequently observed in PVPM fractures, the clinical necessity of IAIF reduction remains controversial, and the prognostic significance of IAIF presence or malreduction remains unclear. This retrospective study investigated prognostic factors in 64 surgically treated PVPM fractures with 24-month follow-up. Patients were divided into groups based on their reduction quality. Postoperative articular stepping and/or separation ≥ 2 mm were/was considered "poor" reduction, otherwise "optimal or good". AOFAS is the primary outcome while the VAS pain score, the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) are secondary outcomes. Statistical differences of in AOFAS, SF-36 and VAS were observed between reduction quality groups with the optimal reduction showing significantly better outcomes at postoperative 24 months. Statistical difference of AOFAS, SF-36 and VAS was also found between the sex groups with female cases showing significantly poorer outcomes. Neither IAIF's presence, size, morphological difference or location affected the prognosis. Based on linear regression analysis, "female", "poor reduction" and "syndesmotic fixation" are categorical variables that impair the functional prognosis of PVPM fractures at postoperative 24 months. This study indicates that the reduction quality based on articular stepping and separation was positively associated with clinical outcomes in PVPM fractures at 24 months postoperatively, which is independent of IAIF. Therefore, regardless of the presence of the IAIF, the reduction quality of the articular congruity positively affects the prognosis of PVPM fracture.

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来源期刊
Journal of Foot & Ankle Surgery
Journal of Foot & Ankle Surgery ORTHOPEDICS-SURGERY
CiteScore
2.30
自引率
7.70%
发文量
234
审稿时长
29.8 weeks
期刊介绍: The Journal of Foot & Ankle Surgery is the leading source for original, clinically-focused articles on the surgical and medical management of the foot and ankle. Each bi-monthly, peer-reviewed issue addresses relevant topics to the profession, such as: adult reconstruction of the forefoot; adult reconstruction of the hindfoot and ankle; diabetes; medicine/rheumatology; pediatrics; research; sports medicine; trauma; and tumors.
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