单侧踝关节骨折患者术后踝关节功能恢复情况及其与Danis-Weber分型和踝穴形态的关系研究  

Postoperative ankle function recovery of patients with unilateral ankle fracture and its relationship with Danis-Weber classifications and morphology of the ankle mortise

作　　者：邱大权 胡靖[1] QIUDa-quan;HU Jing(Department of Orthopaedics,Anqing Municpal Hospital,Anhui,246000,China)

机构地区：[1]安庆市立医院骨科,安徽省246000

出　　处：《中国骨与关节杂志》2024年第11期890-895,共6页Chinese Journal of Bone and Joint

摘　　要：目的探讨单侧踝关节骨折患者术后踝关节功能恢复情况及其与Danis-Weber分型和踝穴形态的关系。方法回顾分析2020年1月至2022年10月,82例单侧踝关节骨折患者。入院后行踝关节X线及CT检查,判断骨折Danis-Weber分型、踝穴形态。行踝关节骨折切开复位内固定术,术后1年随访评估Mazur踝关节功能评分。采用多因素Logistic回归分析影响术后踝关节功能恢复的危险因素。结果术后Mazur踝关节功能评分显示优42例,良25例,可15例。踝关节功能优的患者Danis-Weber分型A型的比例高于踝关节功能可的患者,且C型的比例低于踝关节功能可的患者(66.67%vs.26.67%;4.76%vs.46.67%;P<0.05)。踝关节功能优的患者的踝穴高度差值、踝穴宽度差值、踝穴深度差值、冠状位角度差值、矢状位角度差值为(0.28±0.04)mm、(0.84±0.21)mm、(1.56±0.40)mm、(2.37±0.60)°、(1.22±0.31)°,均小于踝关节功能良[(0.32±0.05)mm、(1.03±0.26)mm、(2.17±0.55)mm、(4.64±1.17)°、(2.45±0.62)°]、可[(0.40±0.08)mm、(2.75±0.69)mm、(3.89±0.98)mm、(5.80±1.46)°、(4.69±1.20)°]的患者(P<0.05)。年龄≥60岁(OR=2.815)、Danis-Weber分型C型(OR=3.053)是影响术后踝关节功能恢复不良的危险因素(P<0.05)。结论单侧踝关节骨折患者术后踝关节功能恢复情况与Danis-Weber分型和踝穴形态密切相关,高龄、踝穴形态异常的患者术后踝关节功能恢复不良的风险较高。Objective To investigate postoperative ankle function recovery of patients with unilateral ankle fracture and its relationship with Danis-Weber classifications and morphology of the ankle mortise.Methods A retrospective study from June 2020 to January 2022 was conducted,including 82 patients with unilateral ankle fracture.All patients received X-ray and CT examinations of the ankle joint after admission to determine the Danis-Weber type of fracture and the morphology of ankle mortise.The patients were treated with open reduction and internal fixation for the ankle fracture.Mazur score of the ankle function 1 year after surgery was recorded.Multivariate logistic regression analysis was conducted to identify the risk factors influencing postoperative recovery of the ankle function.Results The postoperative Mazur score of the ankle function was excellent in 42 cases,good in 25 cases and fair in 15 cases.The proportion of Danis-Weber type A ankle fractures in patients with excellent ankle function was higher than that in patients with general ankle function;and the proportion of type C ankle fractures was lower than that in patients with general ankle function(66.67%vs.26.67%;4.76%vs.46.67%,P<0.05).The difference values of ankle mortise height,ankle mortise width,ankle mortise depth,coronal angle and sagittal angle of patients with excellent ankle function[(0.28±0.04)mm,(0.84±0.21)mm,(1.56±0.40)mm,(2.37±0.60)°and(1.22±0.31)°]were lower than those of patients with good ankle function[(0.32±0.05)mm,(1.03±0.26)mm,(2.17±0.55)mm,(4.64±1.17)°and(2.45±0.62)°]and those with general ankle function[(0.40±0.08)mm,(2.75±0.69)mm,(3.89±0.98)mm,(5.80±1.46)°and(4.69±1.20)°](P<0.05).Age≥60 years(OR=2.815)and Danis-Webertype C(OR=3.053)were risk factors for poor postoperative recovery of the ankle function(P<0.05).Conclusions The postoperative recovery of ankle function in patients with unilateral ankle fracture is closely related toDanis-Weber classifications and morphology of the ankle mortise.Older patients w

关 键 词：踝关节 骨折固定术 内 踝骨折 Danis-Weber分型 

分 类 号：R683.4[医药卫生—骨科学]