Background： Patellar dislocation is one of the most common knee injuries in the adolescent population. It is often combined with osteochondral fracture. The purpose of this study was to cornpare the outcomes between ...Background： Patellar dislocation is one of the most common knee injuries in the adolescent population. It is often combined with osteochondral fracture. The purpose of this study was to cornpare the outcomes between fixation and excision of osteochondral fractures not involving the bearing surface in adolescent patients with patellar dislocations. Methods： Patients who underwent surgery for osteochondral fracture following patellar dislocation in our institution from 2007 to 2014 were retrospectively evaluated. Visual analog scale （VAS） of pain and the International Knee Documentation Committee （IKI）C） form were used to assess knee pain and function at follow-up. Patient satisfaction was evaluated. Differences in the values of variables among groups were assessed using t-test if equal variance or Mann-Whitney U-test if not equal variance. The Pearson＇s Chi-square test was applied for dichotomous variables if expected frequency was 〉5 or Fisher＇s exact test was applied if not. A value of P 〈 0.05 was considered statistically significant. Results： Forty-three patients were included, with the average age of 14.1 ± 2.3 （range, 9.0-17.0） years. Nineteen underwent fixation of osteochondral fractures and 24 did not. The average follow-up time was 28 ± 10 months. There was no significant difference in age, gender, follow-up time, causes of injury, times of dislocation, and location of osteochondral fracture between fixation and excision groups. The fixation group had a significantly longer surgery time （82± 14 rain） and larger size of osteochondral fracture （2.30 ±0.70 cm2） than the excision group （43 ± 10 min, 1.88 ± 0.62 cm2, respectively, t = 10,77, P 〈 0.01 and t = 0.84, P 〈 0.05）. At the last follow-up, the average I KDC score in the fixation group （82.52 ± 8.71 ） was significantly lower than that in the excision group （89.51 ± 7.19, t 2.65, P 〈 0.01 ）. There was no significant difference in VAS of pain and patients＇ satisfaction. There were 7 （16%）展开更多
Ankle fractures are one of the most common injuries treated by orthopaedic surgeons. A minority of patients with ankle fractures go on to develop persistent pain following anatomical reduction. These sequelae may aris...Ankle fractures are one of the most common injuries treated by orthopaedic surgeons. A minority of patients with ankle fractures go on to develop persistent pain following anatomical reduction. These sequelae may arise as a result of untreated ligamentous or chondral injuries. This study aims to correlate acute arthroscopic ankle findings with the <i><span>Lauge-Hansen </span></i><span>fracture pattern classification. We further aim to compare subjective functional outcomes at least one year following surgery between patients who have received Open Reduction and Internal Fixation (ORIF) alone, </span><b><i><span>versus</span></i></b><i><span> </span></i><span>ORIF </span><i><span>plus</span></i><span> arthroscopy. This is a retrospective case series of patients who have undergone ankle fracture ORIF +/</span><span>-</span><span> arthroscopy from July 2014 to July 2017 inclusive. Each patient’s presenting radiograph was classified according to the </span><i><span>Lauge-Hansen</span></i><span> ankle fracture classification with subsequent correlation to intra-operative arthroscopic findings. Functional outcome at a minimum of one year was evaluated with the American Academy of Orthopaedic Surgeons (AAOS) metric. Twenty two patients underwent ankle ORIF plus arthroscopy (Group A) with a further 26 patients receiving ORIF alone (Group B). 1 in 3 supination-external-rotation type II (SER II) injuries possessed a concomitant syndesmosis injury or osteochondral lesion (OCL) on arthroscopy. 1 in 3 patients with a</span><span>n</span><span> SER IV injury had an osteochondral lesion. The mean AAOS score achieved for Group A was 89.6 (±7.9) with the mean score for Group B being 82.0 (±13.7). In conclusion, ankle arthroscopy aids the diagnosis and treatment of ligamentous and osteochondral injuries not evident on plain film with subsequent superior short-term outcomes</span><span>.</span>展开更多
基金This work was supported by grants from the General Financial Grant from the China Postdoctoral Science Foundation （No. 2016M602846）, the National Natural Science Foundation of China （No. 81702210）, and the Shaanxi Postdoctoral Science Foundation （No. 2017BSHQYXMZZ 16）.
文摘Background： Patellar dislocation is one of the most common knee injuries in the adolescent population. It is often combined with osteochondral fracture. The purpose of this study was to cornpare the outcomes between fixation and excision of osteochondral fractures not involving the bearing surface in adolescent patients with patellar dislocations. Methods： Patients who underwent surgery for osteochondral fracture following patellar dislocation in our institution from 2007 to 2014 were retrospectively evaluated. Visual analog scale （VAS） of pain and the International Knee Documentation Committee （IKI）C） form were used to assess knee pain and function at follow-up. Patient satisfaction was evaluated. Differences in the values of variables among groups were assessed using t-test if equal variance or Mann-Whitney U-test if not equal variance. The Pearson＇s Chi-square test was applied for dichotomous variables if expected frequency was 〉5 or Fisher＇s exact test was applied if not. A value of P 〈 0.05 was considered statistically significant. Results： Forty-three patients were included, with the average age of 14.1 ± 2.3 （range, 9.0-17.0） years. Nineteen underwent fixation of osteochondral fractures and 24 did not. The average follow-up time was 28 ± 10 months. There was no significant difference in age, gender, follow-up time, causes of injury, times of dislocation, and location of osteochondral fracture between fixation and excision groups. The fixation group had a significantly longer surgery time （82± 14 rain） and larger size of osteochondral fracture （2.30 ±0.70 cm2） than the excision group （43 ± 10 min, 1.88 ± 0.62 cm2, respectively, t = 10,77, P 〈 0.01 and t = 0.84, P 〈 0.05）. At the last follow-up, the average I KDC score in the fixation group （82.52 ± 8.71 ） was significantly lower than that in the excision group （89.51 ± 7.19, t 2.65, P 〈 0.01 ）. There was no significant difference in VAS of pain and patients＇ satisfaction. There were 7 （16%）
文摘Ankle fractures are one of the most common injuries treated by orthopaedic surgeons. A minority of patients with ankle fractures go on to develop persistent pain following anatomical reduction. These sequelae may arise as a result of untreated ligamentous or chondral injuries. This study aims to correlate acute arthroscopic ankle findings with the <i><span>Lauge-Hansen </span></i><span>fracture pattern classification. We further aim to compare subjective functional outcomes at least one year following surgery between patients who have received Open Reduction and Internal Fixation (ORIF) alone, </span><b><i><span>versus</span></i></b><i><span> </span></i><span>ORIF </span><i><span>plus</span></i><span> arthroscopy. This is a retrospective case series of patients who have undergone ankle fracture ORIF +/</span><span>-</span><span> arthroscopy from July 2014 to July 2017 inclusive. Each patient’s presenting radiograph was classified according to the </span><i><span>Lauge-Hansen</span></i><span> ankle fracture classification with subsequent correlation to intra-operative arthroscopic findings. Functional outcome at a minimum of one year was evaluated with the American Academy of Orthopaedic Surgeons (AAOS) metric. Twenty two patients underwent ankle ORIF plus arthroscopy (Group A) with a further 26 patients receiving ORIF alone (Group B). 1 in 3 supination-external-rotation type II (SER II) injuries possessed a concomitant syndesmosis injury or osteochondral lesion (OCL) on arthroscopy. 1 in 3 patients with a</span><span>n</span><span> SER IV injury had an osteochondral lesion. The mean AAOS score achieved for Group A was 89.6 (±7.9) with the mean score for Group B being 82.0 (±13.7). In conclusion, ankle arthroscopy aids the diagnosis and treatment of ligamentous and osteochondral injuries not evident on plain film with subsequent superior short-term outcomes</span><span>.</span>
