基于Bartonicek分型的内固定治疗踝关节后Plion骨折的效果及预后影响因素分析

Effects of internal fixation based on Bartonicek classification in the treatment of posterior Plion fracture of the ankle and prognostic factors

目的探讨分析基于Bartonicek分型的内固定治疗踝关节后Plion骨折的效果及预后影响因素。方法选择2016年1月至2018年6月我院基于Bartonicek分型的内固定治疗并获得随访的73例踝关节后Plion骨折患者作为研究对象,依据美国足踝骨科协会(American Orthopedic Foot Ankle Society,AOFAS)推荐的踝-后足功能评分标准评估治疗效果,分析踝关节后Plion骨折患者预后影响因素。结果所有患者在末次随访时均获得骨性愈合,术后踝关节功能评分优良率为83.56%,其中优35例,良26例,可12例,经多元Logistic回归分析,年龄、是否存在合并伤、术后开始锻炼时间及Bartonicek分型是踝关节后Plion骨折患者预后影响因素。结论基于Bartonicek分型的内固定是治疗踝关节后Plion骨折的有效方法,对患者的踝关节功能改善效果明显。踝关节后Plion骨折患者的年龄、是否存在合并伤、术后开始锻炼时间及Bartonicek分型是其预后的影响因素,临床治疗时应针对影响因素对患者采取个体化治疗。

Objective To explore and analyze the effects and prognostic factors of internal fixation based on Bartonicek classification in the treatment of posterior Plion fracture of the ankle.Methods From January 2016 to June 2018,73 patients with post-ankle Plion fracture underwent internal fixation based on Bartonicek classification.American Foot and Ankle Orthopedics Association (AOFAS) and the posterior foot function scoring standard were used to evaluate the treatment effects and prognostic factors.Results Bone healing was achieved in all patients at the last follow-up.The excellent and good rate of the ankle postoperatively was 83.56% (excellent in 35 cases,good in 26 cases,fair in 12 cases).Age,combined injury,initial post-operative exercise and Bartonicek classification were prognostic factors of posterior Plion fracture of the ankle by multiple logistic regression analysis.Conclusions Internal fixation based on Bartonicek classification is effective in the treatment of posterior Plion fracture of the ankle and improvement of ankle functions,while age,combined injury,initial post-operative exercise and Bartonicek classification are prognostic factors.Individual treatment is recommended in clinic.