基于踝穴形态参数和足底压力特征预测踝关节骨折术后踝关节不稳的风险  

Prediction risk of ankle instability after ankle fracture surgery based on ankle mortise morphological parameters and plantar pressure characteristics

作　　者：刘玉波 田更双 郑丽红 张宇 张同润 LIU Yu-bo;TIAN Geng-shuang;ZHENG Li-hong;ZHANG Yu;ZHANG Tong-run(Department of No.4 Osteology,North China Medical Health Group Xingtai General Hospital,Xingtai 054000,Hebei,China)

机构地区：[1]华北医疗健康集团邢台总医院骨四科,河北邢台054000

出　　处：《生物医学工程与临床》2025年第1期87-92,共6页Biomedical Engineering and Clinical Medicine

基　　金：河北省邢台市科技计划项目(2019ZC241)。

摘　　要：目的基于踝穴形态参数和足底压力特征预测踝关节骨折术后踝关节不稳的风险。方法选择华北医疗健康集团邢台总医院2020年1月至2023年1月接受踝关节骨折手术治疗的患者200例,其中男性100例,女性100例;年龄36~80岁,平均年龄68.21岁;损伤后至手术时间12~17 h,平均时间15.05 h;损伤原因,车祸62例,扭伤61例,砸伤27例,高处坠落伤28例,其他22例。根据术后12个月的踝关节功能评分将其分为踝关节不稳组和踝关节稳定组,检测两组患者踝穴形态参数及足底压力特征,Spearman相关性分析踝穴形态参数、足底压力特征与踝关节不稳的相关性。结果根据术后12个月的踝关节功能评分将其分为踝关节不稳组(n=100)和踝关节稳定组(n=100)。两组患者年龄差异有统计学意义(P<0.05),性别、损伤后至手术时间及原因差异无统计学意义(P>0.05)。踝关节不稳组患者踝穴宽度、踝穴深度、冠状位角度、矢状位角度均显著高于踝关节稳定组[(44.64±2.74)mm vs(41.07±2.32)mm、(39.98±2.37)mm vs(37.24±2.12)mm、(8.02±1.28)°vs(7.29±1.06)°、(15.84±2.04)°vs(14.38±1.56)°。P<0.05],但两组踝穴高度差异无统计学意义(P>0.05)。踝关节不稳组患者的足底压力峰值、足底平均压力、足底接触面积、足底接触时间均显著低于踝关节稳定组[(258.25±60.46)kPa vs(279.38±70.87)kPa、(76.58±11.49)kPa vs(82.84±14.28)kPa、(102.21±10.48)cm2vs(108.02±11.58)cm2、(1.02±0.23)s vs(1.14±0.28)s。P<0.05],足内侧压力百分比、行走速度略低于踝关节稳定组,足外侧压力百分比略高于踝关节稳定组,但差异无统计学意义(P>0.05)。Spearman相关性分析显示年龄、踝穴宽度、踝穴深度、冠状位角度、矢状位角度与踝关节不稳呈显著正相关(r=0.170、0.210、0.140、0.260、0.160,P<0.05),足底压力峰值、足底平均压力、足底接触面积、足底接触时间与踝关节不稳呈显著负相关(r=-0.380、-0.190、-0.540�Objective To predict the risk of ankle instability after ankle fracture surgery based on ankle morphological parameters and plantar pressure characteristics.Methods From January 2020 to January 2023,a total of 200 ankle fractures patients performed surgery were enrolled,which included 100 males and 100 females,aged 36-80 years old with mean age of 68.21 years old.The time from injury to surgery was 12-17 hours with mean time of 15.05 hours.There were 62 cases of traffic accidents,61 of sprains,27 of bruises,28 of high fall injuries and 22 of other injuries.According to ankle function score at 12-month after surgery,all of them were divided into ankle instability group and ankle stability group.The ankle morphological parameters and plantar pressure characteristics of 2 groups were detected,and Spearman correlation analysis was used to analyze the correlation between ankle instability and ankle morphological parameters,as well as ankle instability and plantar pressure characteristics.Results According to ankle function score at 12-months after surgery,all patients were divided into ankle instability group(n=100)and ankle stability group(n=100).There were statistically significant differences in age between 2 groups(P<0.05),but there were no statistically significant differences in gender,time from injury to surgery and cause between 2 groups(P>0.05).The ankle width,ankle depth,coronal angle and sagittal angle of ankle instability group were significantly higher than those of ankle stability group[(44.64±2.74)mm vs(41.07±2.32)mm,(39.98±2.37)mm vs(37.24±2.12)mm,(8.02±1.28)°vs(7.29±1.06)°,(15.84±2.04)°vs(14.38±1.56)°.P<0.05],but there was no significant difference in height of ankle mortises between 2 groups(P>0.05).In ankle instability group,the peak plantar pressure,mean plantar pressure,plantar contact area and plantar contact time were significantly lower than those in ankle stability group[(258.25±60.46)kPa vs(279.38±70.87)kPa,(76.58±11.49)kPa vs(82.84±14.28)kPa,(102.21±10.48)cm2 vs(108.02±11.5

关 键 词：踝关节骨折 踝关节不稳 踝穴形态 足底压力 风险预测 

分 类 号：R687.3[医药卫生—骨科学]