踝关节骨折患者术后踝关节不稳发生的高危因素

High-risk Factors of Postoperative Ankle Instability in Patients with Ankle Fracture

目的:观察踝关节骨折患者术后踝关节不稳发生情况,并探讨影响术后发生踝关节不稳的相关因素。方法:选取医院2019年1月-2021年1月收治的踝关节骨折患者共96例,均于本院接受切开复位内固定术治疗并接受为期1年随访,依据足踝表现评分量表(FAOS)评估患者踝关节功能性稳定情况并进行分组;由研究人员询问患者基线资料并记录研究所需资料,将可能的影响因素纳入,分析踝关节骨折患者术后踝关节不稳发生的相关因素。结果:96例踝关节骨折患者术后1年经评估,有30例患者发生踝关节不稳,占比为31.25%;发生组骨折分型、跟骨牵引、早期功能锻炼、术后并发症与未发生组比较,差异有统计学意义(P<0.05);组间其他基线资料比较,差异无统计学意义(P>0.05);经Logistic回归分析,结果显示,骨折分型为C型、未跟骨牵引、未早期功能锻炼以及有术后并发症均是踝关节骨折患者术后踝关节不稳发生的影响因素(OR>1,P<0.05)。结论:踝关节骨折患者术后踝关节不稳发生可能与骨折分型为C型、未跟骨牵引、未早期功能锻炼、有术后并发症等因素有关。

Objective:To observe the occurrence of postoperative ankle instability in patients with ankle fracture,and to explore the related factors affecting postoperative ankle instability.Methods:A total of 96 patients with ankle fracture treated in a hospital from January 2019 to January 2021 were selected,all were treated with open reduction and internal fixation and received one year of follow-up.The functional stability of ankle joint of patients was evaluated according to foot and ankle outcome score(FAOS),and then all patients were grouped;The researchers asked the patients about the baseline data,recorded the data required for the study,included the possible influencing factors,and analyzed the related factors of postoperative ankle instability in patients with ankle fracture.Results:One year after operation,30 of 96 patients with ankle fracture developed ankle instability,accounting for 31.25%.There was statistically significant difference in fracture classification,calcaneal traction,early functional exercise and postoperative complications between the occurrence group and the non occurrence group(P<0.05).There was no statistically significant difference in other baseline data between the two groups(P>0.05).The Logistic regression analysis showed that fracture type C,no calcaneal traction,no early functional exercise and postoperative complications were the influencing factors of postoperative ankle instability in patients with ankle fracture(OR>1,P<0.05).Conclusion:The occurrence of postoperative ankle instability in patients with ankle fracture may be related to the factors such as fracture type C,no calcaneal traction,no early functional exercise,postoperative complications and so on.