Long-term results of ankle fractures with a posterior malleolar fragment.
Long-term results of ankle fractures with a posterior malleolar fragment.
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DOI：
10.1053/j.jfas.2005.02.002
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发表时间：
2005-05-01
期刊：
影响因子：
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通讯作者：
Schaap, G R
中科院分区：
文献类型：
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作者：
De Vries, J S;Wijgman, A J;Schaap, G R
本研究的目的是评估 1) 伴有后踝碎片的踝关节骨折的长期结果，以及 2) 固定小于 25% 碎片的需要。对 45 名踝关节骨折和后踝骨折的患者进行了评估。平均随访时间为 13 年（范围：2-24 年）。记录片段的大小和固定。使用踝关节骨折评分系统（最高分：150 分）、10 分疼痛数字量表（1 = 无疼痛，10 = 难以忍受的疼痛）和骨关节炎评分（0 = 无骨关节炎，3 = 严重骨关节炎）来评估结果。平均踝关节骨折评分系统、疼痛数字量表和骨关节炎评分分别为 124、2.5 和 1.2。固定片段的平均大小明显大于非固定片段的平均大小（30% 对 16%）。与未固定后踝碎片的患者相比，固定后踝碎片的患者没有具有统计学上显着的更好结果（踝关节骨折评分系统：119 与 126，疼痛数字量表：2.6 与 2.4，骨关节炎评分：1.0 与 1.2）。结果和未固定碎片的大小之间没有显着相关性。骨折脱位更常见于较大碎片（24% 对 15%），并且除了疼痛之外，其长期结果比非脱位骨折具有统计显着性更差（踝关节骨折评分系统：115 对 134，骨关节炎评分：1.7 对 0.8）。总之，患者在13年的随访后显示出良好的结果，并且没有证据表明需要对小于25%的碎片进行固定。
The aim of this study was to evaluate 1) long-term results of ankle fractures with a posterior malleolar fragment, and 2) the need for fixation of fragments smaller than 25%. Forty-five patients with ankle fractures and a posterior malleolar fragment were evaluated. Mean follow-up was 13 years (range, 2-24). The size and fixation of the fragment were registered. Outcome was assessed using an Ankle Fracture Scoring System (maximum: 150 points), a 10-point Numeric Scale for Pain (1 = no pain, 10 = unbearable pain) and an OsteoArthritis Score (0 = no osteoarthritis, 3 = severe osteoarthritis). The mean Ankle Fracture Scoring System, Numeric Scale for Pain and Osteoarthritis-score were 124, 2.5, and 1.2, respectively. The mean size of fixated fragments was significantly larger than that of nonfixated fragments (30% versus 16%). Those patients in which the posterior malleolar fragment was fixated did not have a statistically significant better outcome than those patients in which the fragments were not fixated (Ankle Fracture Scoring System: 119 versus 126, Numeric Scale for Pain: 2.6 versus 2.4, Osteoarthritis-score: 1.0 versus 1.2). There was no significant correlation between outcome and size of unfixated fragments. Fracture-dislocation was seen more often in combination with larger fragments (24% versus 15%) and resulted in statistically significant worse long-term outcome than nondislocated fractures, except for pain (Ankle Fracture Scoring System: 115 versus 134, Osteoarthritis-score: 1.7 versus 0.8). In conclusion, patients showed good results after 13 years follow-up and there was no evidence for the need for fixation of fragments smaller than 25%.