Patient-Reported Outcomes After Lateral Process Talus Fracture.

Szczegóły
Abstrakt

Tytuł:: Patient-Reported Outcomes After Lateral Process Talus Fracture.
Autorzy:: Ross H; Department of Orthopedic Surgery, Metro Health Hospital-University of Michigan Health, Wyoming, MI; and.
Marchand L; Department of Orthopaedic Surgery, University of Utah School of Medicine, Salt Lake City, UT.
Cardon J; Department of Orthopaedic Surgery, University of Utah School of Medicine, Salt Lake City, UT.
Beals T; Department of Orthopaedic Surgery, University of Utah School of Medicine, Salt Lake City, UT.
Barg A; Department of Orthopaedic Surgery, University of Utah School of Medicine, Salt Lake City, UT.
Nickisch F; Department of Orthopaedic Surgery, University of Utah School of Medicine, Salt Lake City, UT.
Haller JM; Department of Orthopaedic Surgery, University of Utah School of Medicine, Salt Lake City, UT.
Źródło:: Journal of orthopaedic trauma [J Orthop Trauma] 2021 Dec 01; Vol. 35 (12), pp. e470-e474.
Typ publikacji:: Journal Article
Język:: English
Imprint Name(s):: Publication: Hagerstown, MD : Lippincott Williams & Wilkins
Original Publication: [New York, N.Y.] : Raven Press, [c1987-
MeSH Terms:: Ankle Fractures*/diagnostic imaging
Ankle Fractures*/surgery
Talus*/diagnostic imaging
Talus*/surgery
Activities of Daily Living ; Adolescent ; Adult ; Fracture Fixation, Internal ; Humans ; Middle Aged ; Patient Reported Outcome Measures ; Retrospective Studies ; Treatment Outcome ; Young Adult
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Entry Date(s):: Date Created: 20210606 Date Completed: 20220127 Latest Revision: 20220127
Update Code:: 20240105
DOI:: 10.1097/BOT.0000000000002099
PMID:: 34091571
: Czasopismo naukowe

Objectives: To evaluate functional outcome after lateral process talus fracture using patient-reported instruments and identify injury characteristics that portend a worse prognosis.
Design: Retrospective case series.
Setting: Level 1 academic trauma center.
Patients/participants: Fifty-three patients with isolated lateral process talus fracture and 12 months of minimum follow-up.
Main Outcome Measurements: Patient-Reported Outcomes Measurement Information System (PROMIS) physical function (PF) and Foot and Ankle Ability Measure (FAAM).
Results: Mean patient age was 33 years (range, 17-62 years), and mean follow-up was 6.5 years (range, 1-12 years). Twenty-one patients were initially treated nonoperatively and 14 of these patients (67%) failed nonoperative management. Patients who failed nonoperative treatment more commonly had a displaced fracture (12 patients) (P = 0.009). Thirty-two patients had displaced fracture and were treated with early operative fixation. For the entire cohort, final PROMIS PF was 55 (SD -8.3), FAAM Activities of Daily Living (ADL) was 89 (SD -14), and FAAM sport was 77 (SD -20). The patients treated with operative fixation had significantly larger fracture fragments (2050 vs. 1066 mm3, P = 0.017). There was no difference in final outcome between operative and nonoperative patients for PROMIS PF (P = 0.84), FAAM ADL (P = 0.95), or FAAM sport (P = 0.94). There were significantly more subtalar fusions in the nonoperative group (4 patients) as compared to the operative group (one patient) (P = 0.05).
Conclusions: Most patients with lateral process talus fracture achieve excellent outcome as measured by the PROMIS PF and FAAM at medium-term follow-up. Displaced fractures are likely best managed with early surgical treatment. Patients treated with early surgery have significantly fewer subtalar fusions as compared to patients with nonoperative treatment.
Level of Evidence: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
Competing Interests: J.M. Haller is a paid lecturer for AO North America and paid consultant for Newclip Technics. The remaining authors report no conflict of interest.
(Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.)

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