摘要
目的探讨影响踝关节骨折患者术后功能的相关因素。方法回顾性研究2005年1月至2008年1月间收治的且获得完整随访资料的102例踝关节骨折患者资料，记录其年龄、性别、体重指数、骨折类型、受伤至手术时间、骨折解剖复位情况及术后有无石膏外固定。应用术后x线片及Baird—Jackson评分系统对术后患者踝关节功能情况进行评分。对上述因素与术后踝关节功能的关系进行多因素分析。结果102例患者获得11～43个月（平均24．7个月）随访。分析发现年龄、骨折类型及骨折复位情况与术后踝关节功能呈负相关，而性别、体重指数、受伤至手术时问及术后有无石膏外固定与踝关节功能无明显相关性。外踝骨折伴有内侧副韧带损伤中内侧副韧带的保守治疗及下胫腓联合损伤处不恰当处理导致患者术后踝关节功能较差。结论年龄越大、骨折类型越复杂，复位越不理想、踝关节功能越差。内侧三角韧带及下胫腓联合损伤的正确处理与否亦在一定程度上影响了患者术后踝关节功能。
Objective To discuss the factors which affect the postoperative functions of the ankle joint. Methods A retrospective study was done of 102 patients who had been diagnosed as malleolar fracture and operated on in our institute between January 2005 and January 2008. We recorded their age, gender, body mass index（BMI）, fracture type （AO type）, time from injury to operation and presence or absence of cast immobilization. Their ankle functions were evaluated by X-ray and the Baird-Jackson evaluation system in regular follow-up. Relationship between the above-mentioned factors and the postoperative functions of the ankle joint was statistically analyzed, using univariate logistic regression and multiple stepwise logistic regression. Results A total of 102 patients were followed up for 24.7 （11 to 43） months. A negative correlation between the age, fracture type, reduction and postoperative function was found. The gender, body mass index （BMI）, time from injury to operation and presence or absence of cast immobilization, however, had no association with the postoperative function. The conservative treatment of the deltoid ligament injury complicated with the lateral malleolar fracture and/or improper treatment of the syndesrnotic injury led to poor function. Conclusions The older a patient and the more serious a fracture, as well as the more unsatisfactory the reduction, the poorer the postoperative ankle functions may be. To some extent, rational treatment of the deltoid ligament injury complicated with the lateral malleolar fracture and the syndesmotic injury may also determine the postoperative function of the ankle joint.
出处
《中华创伤骨科杂志》
CAS
CSCD
2009年第5期446-449,共4页
Chinese Journal of Orthopaedic Trauma
基金
国家“十一五”科技支撑计划基金（2007BAI04806）
关键词
踝关节
骨折
治疗结果
Ankle joint
Fracture
Treatment outcome
