Patient-Reported Outcomes After Lateral Process Talus Fracture
| Autor: | Timothy C. Beals, Lucas S. Marchand, Florian Nickisch, Alex Barg, Jeffery Cardon, Hunter Ross, Justin M. Haller |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Adult
medicine.medical_specialty Activities of daily living Adolescent Physical function Ankle Fractures Talus Fracture Fixation Internal Young Adult Activities of Daily Living Humans Medicine Orthopedics and Sports Medicine Patient Reported Outcome Measures Retrospective Studies Talus fracture business.industry Trauma center General Medicine Middle Aged Surgery Nonoperative treatment Treatment Outcome medicine.anatomical_structure Cohort Ankle business Operative fixation |
| Zdroj: | Journal of Orthopaedic Trauma. 35:e470-e474 |
| ISSN: | 0890-5339 |
| DOI: | 10.1097/bot.0000000000002099 |
| Popis: | 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. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|