Bartonicek分型2型踝关节骨折中后踝骨折和下胫腓联合损伤对踝关节功能的预后影响  

Effects of area of the posterior malleolus fracture and injury to the distal tibiofibular syndesmosis on functional recovery of the ankle in Bartonicek type 2 ankle fractures

作　　者：韩策 喻健 王之峰 宋佳峰 耿翔 张超 王旭 Han Ce;Yu Jian;Wang Zhifeng;Song Jiafeng;Geng Xiang;Zhang Chao;Wang Xu(Department of Orthopedics,Huashan Hospital Affiliated to Fudan University,Shanghai 200040,China)

机构地区：[1]复旦大学附属华山医院骨科,上海200040

出　　处：《中华创伤骨科杂志》2025年第1期52-56,共5页Chinese Journal of Orthopaedic Trauma

基　　金：国家自然科学基金面上项目(81772416)。

摘　　要：目的探讨Bartonicek分型2型踝关节骨折中后踝骨折及下胫腓联合损伤对踝关节术后功能恢复的影响。方法回顾性分析2016年1月至2022年1月复旦大学附属华山医院收治的47例Bartonicek分型2型踝关节骨折患者资料。男22例,女25例;年龄(46.0±15.6)岁。所有患者均行切开复位内固定。采用Pearson相关分析和多元回归分析患者术前后踝骨折块面积占比,下胫腓前、后距离分别与末次随访时美国足踝外科协会(AOFAS)踝-后足评分的关系。结果所有患者术后随访(17.2±0.6)个月。Pearson相关性分析结果显示:后踝骨折块面积占比(P=0.160)和下胫腓后距离(P=0.078)与末次随访时AOFAS踝-后足评分显著相关;下胫腓前距离与末次随访时AOFAS踝-后足评分无显著相关(P=0.689)。多元回归分析结果显示,后踝骨折块面积占比(P=0.043)和下胫腓后距离(P=0.022)均对末次随访时AOFAS踝-后足评分有显著负向影响。结论Bartonicek分型2型踝关节骨折中后踝骨折块面积占比和下胫腓后距离是预测踝关节术后功能恢复的重要因素。Bartonicek分型2型踝关节骨折中后外踝骨折的手术指征不仅取决于骨折块的大小,还取决于骨折是否累及下胫腓联合。ObjectiveTo investigate the effects of area of the posterior malleolus fracture and injury to the distal tibiofibular syndesmosis on functional recovery of the ankle joint in Bartonicek type 2 ankle fractures.MethodsA retrospective analysis was conducted of the clinical data of 47 patients with Bartonicek type 2 ankle fracture who had been treated at Department of Orthopedics,Huashan Hospital Affiliated to Fudan University from January 2016 to January 2022.There were 22 males and 25 females with an age of(46.0±15.6)years.All patients were treated by open reduction and closed reduction.Pearson correlation analysis and multiple regression analysis were used to investigate the relationships respectively between the American Association of Foot and Ankle Surgeons(AOFAS)ankle-hindfoot scores at the last follow-up and the preoperative proportion of posterior ankle fracture area,and the anterior and posterior tibiofibular distances.ResultsAll patients were followed up for(17.2±0.6)months after surgery.The Pearson correlation analysis showed that the proportion of posterior ankle fracture area(P=0.160)and the posterior tibiofibular distance(P=0.078)were significantly correlated with the AOFAS ankle-hindfoot score at the last follow-up.There was no significant correlation between the anterior tibiofibular distance and the AOFAS ankle-hindfoot score at the last follow-up(P=0.689).The multiple regression analysis showed that the proportion of posterior ankle fracture area(P=0.043)and the posterior tibiofibular distance(P=0.022)had significant negative effects on the AOFAS ankle-hindfoot score at the last follow-up.ConclusionsIn Bartoníček type 2 ankle fractures,the proportion of posterior ankle fracture area and the posterior tibiofibular distance are important predictors for postoperative functional recovery of the ankle.Therefore,in Bartonicek type 2 ankle fractures,surgical indications for the posterior malleolar fracture depend not only on the size of the fracture,but also on whether the fracture involves the lower

关 键 词：踝关节 胫骨骨折 成像 三维 下胫腓联合 后踝 

分 类 号：R687.3[医药卫生—骨科学]