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Comparison of results of three different patient-based assessment scales in surgically treated adult ankle fractures

Year 2022, Volume 47, Issue 2, 638 - 651, 30.06.2022
https://doi.org/10.17826/cumj.1051579

Abstract

Purpose: The aim of this study was to evaluate the post-operative clinical and radiological results of ankle fractures, using three different patient-reported outcome measurements (PROM) and to analyze the results and compatibility of the PROMs. Materials and Methods: A total of 77 patients were followed up prospectively. Demographic data, fracture side, trauma mechanisms, fracture types, post-operative splint times, initiation of full weight bearing time, and complications were recorded. All patients were evaluated according to the AOFAS, Ankle-Hindfoot Rating Scale, Weber Scoring and Freiburg Scale, at the first-year follow-ups. Results: The results were good in 57 patients (74%) and poor in 20 patients (26%), according to the AOFAS Scale; excellent in 51 patients (66.2%), good in 12 patients (15.6%) and poor in 14 patients (18.2%) according to the Weber Scoring, and excellent in 50 patients (64.9%), good in 12 patients (15.6%) and poor in 15 patients (19.5%) according to the Freiburg Scale. The results of the PROMs were found to be compatible with each other. Significant relationship was found between the development of complications and the AOFAS Scale and Weber Scoring, and between older age and Weber Scoring. Conclusion: The results of the AOFAS Scale, Weber Score and Freiburg Scales are compatible with each other and can be safely used in the evaluation of ankle fractures. Development of complications and older age are associated with poor clinical outcomes.

References

  • 1. Gencer B, Doğan Ö, Çalışkan E, İğdir V, Biçimoğlu A. Single versus double plating for bicondylar tibia plateau fractures: Comparison of range of motion, muscle strength, clinical outcomes and accelerometer-measured physical activity levels. Knee. 2021; 24;34:187-94.
  • 2. Pina G, Fonseca F, Vaz A, Carvalho A, Borralho N. Unstable malleolar ankle fractures: evaluation of prognostic factors and sports return. Arch Orthop Trauma Surg. 2021;141(1):99-104.
  • 3. Blom RP, Meijer DT, de Muinck Keizer RO, Stufkens SAS, Sierevelt IN, Schepers T, ve ark. Posterior malleolar fracture morphology determines outcome in rotational type ankle fractures. Injury. 2019;50(7):1392-7.
  • 4. Toth MJ, Yoon RS, Liporace FA, Koval KJ. What's new in ankle fractures. Injury. 2017;48(10):2035-41.
  • 5. Carter TH, Duckworth AD, White TO. Medial malleolar fractures: current treatment concepts. Bone Joint J. 2019;101-B(5):512-21.
  • 6. Hughes JL, Weber H, Willenegger H, Kuner EH. Evaluation of ankle fractures: non-operative and operative treatment. Clin Orthop Relat Res. 1979;(138):111-9.
  • 7. Okkaoğlu MC, Ateş A, Yaradılmış YU, Demirkale İ, Evren AT, Altay M. The necessity of bone grafting in the surgical treatment of severely comminuted calcaneus fractures. Cukurova Medical Journal. 2019; 44: 27-32.
  • 8. Bilgin SS, Köse KC, Adiyaman S, Demirtaş M. Ayak bileği lezyonlarinda artroskopik cerrahinin erken dönem fonksiyonel sonuçlari [Early functional results of arthroscopic surgery for ankle lesions]. Acta Orthop Traumatol Turc. 2004;38(1):23-9. Turkish.
  • 9. Mitchell JJ, Bailey JR, Bozzio AE, Fader RR, Mauffrey C. Fixation of distal fibula fractures: an update. Foot Ankle Int. 2014; 35(12):1367-75.
  • 10. Bartoníček J, Rammelt S, Tuček M. Posterior Malleolar Fractures: Changing Concepts and Recent Developments. Foot Ankle Clin. 2017;22(1):125-45.
  • 11. Michelson JD, Wright M, Blankstein M. Syndesmotic Ankle Fractures. J Orthop Trauma. 2018;32(1):10-4.
  • 12. Tartaglione JP, Rosenbaum AJ, Abousayed M, DiPreta JA. Classifications in Brief: Lauge-Hansen Classification of Ankle Fractures. Clin Orthop Relat Res. 2015;473(10):3323-8.
  • 13. Babu V, Feger J. Ankle fractures. https://doi.org/10.53347/rID-46502. (Accessed on 25 Dec 2021)
  • 14. Kitaoka HB, Alexander IJ, Adelaar RS, Nunley JA, Myerson MS, Sanders M. Clinical rating systems for the ankle-hindfoot, midfoot, hallux, and lesser toes. Foot Ankle Int. 1994;15(7):349-53.
  • 15. Asloum Y, Bedin B, Roger T, Charissoux JL, Arnaud JP, Mabit C. Internal fixation of the fibula in ankle fractures: a prospective, randomized and comparative study: plating versus nailing. Orthop Traumatol Surg Res. 2014;100(4 Suppl):S255-9.
  • 16. Lambers KT, van den Bekerom MP, Doornberg JN, Stufkens SA, van Dijk CN, Kloen P. Long-term outcome of pronation-external rotation ankle fractures treated with syndesmotic screws only. J Bone Joint Surg Am. 2013;95(17):e1221-7.
  • 17. Nielsen JO, Dons-Jensen H, Sorensen HT. Lauge-Hansen classification of malleolar fractures. An assessment of the reproducibility in 118 cases. Acta Orthop Scand. 1990;61(5):385-7.
  • 18. Ibrahim T, Beiri A, Azzabi M, Best AJ, Taylor GJ, Menon DK. Reliability and validity of the subjective component of the American Orthopaedic Foot and Ankle Society clinical rating scales. J Foot Ankle Surg. 2007;46(2):65-74. 19. Reuwer JH ve Van Straaten TJ. Evaluation of operative treatment of 193 ankle fractures. Neth J Surg. 1984;36(4):98-102.
  • 20. Du H, Tian XX, Li TS, Chu JJ, Xiong MY, Wang JS ve ark. Treatment of medial malleolus fractures with closed reduction and percutaneous internal fixation]. Zhongguo Gu Shang. 2011;24(9):788-90. Chinese.
  • 21. Palazzo C, Nguyen C, Lefevre-Colau MM, Rannou F, Poiraudeau S. Risk factors and burden of osteoarthritis. Ann Phys Rehabil Med. 2016;59(3):134-8.
  • 22. SooHoo NF, Krenek L, Eagan MJ, Gurbani B, Ko CY, Zingmond DS. Complication rates following open reduction and internal fixation of ankle fractures. J Bone Joint Surg Am. 2009;91(5):1042-9.
  • 23. Ovaska MT, Mäkinen TJ, Madanat R, Huotari K, Vahlberg T, Hirvensalo E, ve ark. Risk factors for deep surgical site infection following operative treatment of ankle fractures. J Bone Joint Surg Am. 2013;20;95(4):348-53.
  • 24. Carbonell-Escobar R, Rubio-Suarez JC, Ibarzabal-Gil A, Rodriguez-Merchan EC. Analysis of the variables affecting outcome in fractures of the tibial pilon treated by open reduction and internal fixation. J Clin Orthop Trauma. 2017;8(4):332-8.

Cerrahi olarak tedavi edilen yetişkin ayak bileği kırıklarında üç farklı hasta bazlı değerlendirme ölçek sonuçlarının karşılaştırılması

Year 2022, Volume 47, Issue 2, 638 - 651, 30.06.2022
https://doi.org/10.17826/cumj.1051579

Abstract

Amaç: Bu çalışmda ayak bileği kırıklarının ameliyat sonrası klinik ve radyolojik sonuçlarının üç farklı hasta bazlı değerlendirme ölçeği kullanılarak değerlendirilmesi ve ölçeklerinin sonuçlarının ve birbirleri ile uyumlarının karşılaştırılması amaçlanmıştır. Gereç ve Yöntem: Yaşları 18 ile 77 arasında değişen toplam 77 hasta prospektif olarak takip edildi. Tüm hastaların yaş, cinsiyet, kırık taraf, travma mekanizmaları, kırık tipleri, ameliyat sonrası atel uygulanma süreleri, tam yük vermeye başlama zamanları ve komplikasyonları kaydedildi. Hastaların 1. yıl kontrollerinde tüm hastalar, AOFAS, Ayak Bileği-Arka Ayak Değerlendirme Ölçeği, Weber Skorlaması ve Freiburg Skalası protokollerine göre incelendi. Bulgular: AOFAS Değerlendirme Ölçeğine göre 57 hastada (%74) iyi ve 20 hastada (%26) kötü sonuç; Weber Skorlamasında 51 hastada (%66,2) mükemmel, 12 hastada (%15,6) iyi ve 14 hastada (%18,2) kötü sonuç ve Freiburg Skalasında 50 hastada (%64,9) mükemmel, 12 hastada (%15,6) iyi ve 15 hastada (%19,5) kötü sonuç elde edilmiştir. AOFAS-Weber, Ölçek sonuçları birbirleri ile uyumlu bulunmuştur. Komplikasyon gelişimi ile AOFAS Değerlendirme Ölçeği ve Weber Skorlaması arasında ve ileri yaş ile Weber Skorlaması arasında anlamlı ilişki saptanmıştır. Sonuç: AOFAS Ölçeği, Weber Skorlaması ve Freiburg Skalalarının sonuçları birbirleri ile uyumlu olup, yetişkin ayak bileği kırıklarının cerrahi tedavisi sonrası değerlendirilmesinde güvenle kullanılabilir. Komplikasyon gelişimi ve ileri yaş, ayak bileği kırıklarında kötü klinik sonuç ile ilişkilendirilebilir.

References

  • 1. Gencer B, Doğan Ö, Çalışkan E, İğdir V, Biçimoğlu A. Single versus double plating for bicondylar tibia plateau fractures: Comparison of range of motion, muscle strength, clinical outcomes and accelerometer-measured physical activity levels. Knee. 2021; 24;34:187-94.
  • 2. Pina G, Fonseca F, Vaz A, Carvalho A, Borralho N. Unstable malleolar ankle fractures: evaluation of prognostic factors and sports return. Arch Orthop Trauma Surg. 2021;141(1):99-104.
  • 3. Blom RP, Meijer DT, de Muinck Keizer RO, Stufkens SAS, Sierevelt IN, Schepers T, ve ark. Posterior malleolar fracture morphology determines outcome in rotational type ankle fractures. Injury. 2019;50(7):1392-7.
  • 4. Toth MJ, Yoon RS, Liporace FA, Koval KJ. What's new in ankle fractures. Injury. 2017;48(10):2035-41.
  • 5. Carter TH, Duckworth AD, White TO. Medial malleolar fractures: current treatment concepts. Bone Joint J. 2019;101-B(5):512-21.
  • 6. Hughes JL, Weber H, Willenegger H, Kuner EH. Evaluation of ankle fractures: non-operative and operative treatment. Clin Orthop Relat Res. 1979;(138):111-9.
  • 7. Okkaoğlu MC, Ateş A, Yaradılmış YU, Demirkale İ, Evren AT, Altay M. The necessity of bone grafting in the surgical treatment of severely comminuted calcaneus fractures. Cukurova Medical Journal. 2019; 44: 27-32.
  • 8. Bilgin SS, Köse KC, Adiyaman S, Demirtaş M. Ayak bileği lezyonlarinda artroskopik cerrahinin erken dönem fonksiyonel sonuçlari [Early functional results of arthroscopic surgery for ankle lesions]. Acta Orthop Traumatol Turc. 2004;38(1):23-9. Turkish.
  • 9. Mitchell JJ, Bailey JR, Bozzio AE, Fader RR, Mauffrey C. Fixation of distal fibula fractures: an update. Foot Ankle Int. 2014; 35(12):1367-75.
  • 10. Bartoníček J, Rammelt S, Tuček M. Posterior Malleolar Fractures: Changing Concepts and Recent Developments. Foot Ankle Clin. 2017;22(1):125-45.
  • 11. Michelson JD, Wright M, Blankstein M. Syndesmotic Ankle Fractures. J Orthop Trauma. 2018;32(1):10-4.
  • 12. Tartaglione JP, Rosenbaum AJ, Abousayed M, DiPreta JA. Classifications in Brief: Lauge-Hansen Classification of Ankle Fractures. Clin Orthop Relat Res. 2015;473(10):3323-8.
  • 13. Babu V, Feger J. Ankle fractures. https://doi.org/10.53347/rID-46502. (Accessed on 25 Dec 2021)
  • 14. Kitaoka HB, Alexander IJ, Adelaar RS, Nunley JA, Myerson MS, Sanders M. Clinical rating systems for the ankle-hindfoot, midfoot, hallux, and lesser toes. Foot Ankle Int. 1994;15(7):349-53.
  • 15. Asloum Y, Bedin B, Roger T, Charissoux JL, Arnaud JP, Mabit C. Internal fixation of the fibula in ankle fractures: a prospective, randomized and comparative study: plating versus nailing. Orthop Traumatol Surg Res. 2014;100(4 Suppl):S255-9.
  • 16. Lambers KT, van den Bekerom MP, Doornberg JN, Stufkens SA, van Dijk CN, Kloen P. Long-term outcome of pronation-external rotation ankle fractures treated with syndesmotic screws only. J Bone Joint Surg Am. 2013;95(17):e1221-7.
  • 17. Nielsen JO, Dons-Jensen H, Sorensen HT. Lauge-Hansen classification of malleolar fractures. An assessment of the reproducibility in 118 cases. Acta Orthop Scand. 1990;61(5):385-7.
  • 18. Ibrahim T, Beiri A, Azzabi M, Best AJ, Taylor GJ, Menon DK. Reliability and validity of the subjective component of the American Orthopaedic Foot and Ankle Society clinical rating scales. J Foot Ankle Surg. 2007;46(2):65-74. 19. Reuwer JH ve Van Straaten TJ. Evaluation of operative treatment of 193 ankle fractures. Neth J Surg. 1984;36(4):98-102.
  • 20. Du H, Tian XX, Li TS, Chu JJ, Xiong MY, Wang JS ve ark. Treatment of medial malleolus fractures with closed reduction and percutaneous internal fixation]. Zhongguo Gu Shang. 2011;24(9):788-90. Chinese.
  • 21. Palazzo C, Nguyen C, Lefevre-Colau MM, Rannou F, Poiraudeau S. Risk factors and burden of osteoarthritis. Ann Phys Rehabil Med. 2016;59(3):134-8.
  • 22. SooHoo NF, Krenek L, Eagan MJ, Gurbani B, Ko CY, Zingmond DS. Complication rates following open reduction and internal fixation of ankle fractures. J Bone Joint Surg Am. 2009;91(5):1042-9.
  • 23. Ovaska MT, Mäkinen TJ, Madanat R, Huotari K, Vahlberg T, Hirvensalo E, ve ark. Risk factors for deep surgical site infection following operative treatment of ankle fractures. J Bone Joint Surg Am. 2013;20;95(4):348-53.
  • 24. Carbonell-Escobar R, Rubio-Suarez JC, Ibarzabal-Gil A, Rodriguez-Merchan EC. Analysis of the variables affecting outcome in fractures of the tibial pilon treated by open reduction and internal fixation. J Clin Orthop Trauma. 2017;8(4):332-8.

Details

Primary Language Turkish
Subjects Medicine
Journal Section Research
Authors

Remzi Can FAKIOĞLU>
Özel Elitpark Hastanesi
0000-0002-7146-2080
Türkiye


Batuhan GENCER> (Primary Author)
SAĞLIK BİLİMLERİ ÜNİVERSİTESİ, ANKARA ŞEHİR SAĞLIK UYGULAMA VE ARAŞTIRMA MERKEZİ, CERRAHİ TIP BİLİMLERİ BÖLÜMÜ, ORTOPEDİ VE TRAVMATOLOJİ ANABİLİM DALI
0000-0003-0041-7378
Türkiye


Ali UTKAN>
SAĞLIK BİLİMLERİ ÜNİVERSİTESİ, ANKARA ŞEHİR SAĞLIK UYGULAMA VE ARAŞTIRMA MERKEZİ, CERRAHİ TIP BİLİMLERİ BÖLÜMÜ, ORTOPEDİ VE TRAVMATOLOJİ ANABİLİM DALI
0000-0002-3653-3998
Türkiye

Supporting Institution Yok
Project Number Yok
Thanks Yok
Publication Date June 30, 2022
Published in Issue Year 2022, Volume 47, Issue 2

Cite

MLA Fakıoğlu, R. C. , Gencer, B. , Utkan, A. "Cerrahi olarak tedavi edilen yetişkin ayak bileği kırıklarında üç farklı hasta bazlı değerlendirme ölçek sonuçlarının karşılaştırılması" . Cukurova Medical Journal 47 (2022 ): 638-651 <https://dergipark.org.tr/en/pub/cumj/issue/69190/1051579>