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Factores asociados a funcionalidad en pacientes con fractura cerrada de tobillo / Factors associated with functionality in patients with closed ankle fracture

Daniel Martínez-Barro, Perla Karina Escalante-Montes, Nallely Contreras-del Carmen, Claudia Stephane Cortes-Aguirre, Diana Peralta-Ildefonso, Hermelinda Hernández-Amaro, David Rojano-Mejía

Resumen


Resumen

Introducción:  las fracturas de tobillo son las fracturas más frecuentes en el miembro inferior. Afectan predominantemente a personas jóvenes y representan aproximadamente el 9% de todas las fracturas.

Objetivo: identificar los factores asociados a funcionalidad en pacientes con fractura cerrada de tobillo.

Material y métodos: estudio observacional y retrospectivo. Se incluyeron expedientes de personas con diagnóstico de fractura cerrada de tobillo ingresados a rehabilitación entre enero y diciembre del 2020 en la Unidad de Medicina Física y Rehabilitación de tercer nivel. Se registró edad, sexo, índice de masa corporal (IMC), días de incapacidad, mecanismo de lesión, tipo de tratamiento, tiempo de estancia en rehabilitación, tipo de fractura y funcionalidad. Para determinar la asociación de las variables con la funcionalidad se utilizó la prueba de chi cuadrada y t de Student, y posteriormente se hizo un análisis multivariado con regresión logística bivariada.

Resultados: la edad promedio de los sujetos fue de 44.8 años, el sexo femenino se presentó en el 54.7%, el IMC promedio fue de 28.8%, 66% realizaba una actividad laboral remunerada, el 65% recibió tratamiento quirúrgico, el tiempo de incapacidad promedio fue de 140 días, los factores asociados a funcionalidad de manera independiente fueron la edad, el dolor, la dorsiflexión y la flexión plantar al ingreso de rehabilitación.

Conclusiones: las fracturas de tobillo se presentan en población joven y los factores asociados a funcionalidad fueron la edad, dorsiflexión, flexión plantar y dolor al ingreso de rehabilitación. 

 

Abstract

Background: Ankle fractures are among the most frequent fractures in the lower limb, predominantly affecting young people and representing approximately 9% of all fractures.

Objective: To identify the factors associated with functionality in patients with closed ankle fracture.

Material and methods: Observational and retrospective study. Records of people with a diagnosis of ankle fractures admitted to rehabilitation between January to December 2020 in a Physical Medicine and Rehabilitation Unit of a third level hospital were included. Age, sex, body mass index (BMI), days of disability, mechanism of injury, type of treatment, length of stay in rehabilitation, type of fracture and functionality were captured. Chi-squared and Student’s t test were used to determine the association. Subsequently a multivariate analysis with binary logistic regression was performed.

Results: The average age of the subjects was 44.8 years, the female sex was presented in 54.7%, the average BMI was 28.8%, 66% carried out a paid work activity, 65% received surgical treatment, the average time of disability was 140 days, the factors associated with functionality independently were age, pain, dorsiflexion and plantar flexion upon admission to rehabilitation.

Conclusions: Ankle fractures occur in a young population and the factors associated with functionality were age, dorsiflexion, plantar flexion, and pain upon admission to rehabilitation.


Palabras clave


Fracturas de Tobillo; Ausencia por Enfermedad; Fijación Interna de Fracturas; Marcha; Funcionalidad / Ankle Fractures; Sick Leave; Fracture Fixation, Internal; Gait; Functionality

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Referencias


 

Daly PJ, Fitzgerald RH, Melton LJ, Llstrup DM. Epidemiology of ankle fractures in Rochester, Minnesota. Acta Orthop. 1987;58(5):539-44. doi: 10.3109/17453678709146395.

 

Dodd AC, Lakomkin N, Attum B, Bulka C, Karhade AV, Douleh DG, et al. Predictors of Adverse Events for Ankle Fractures: An Analysis of 6800 Patients. J Foot Ankle Surg. 2016;55(4):762- 6. doi: 10.1053/j.jfas.2016.03.010.

 

Scheer RC, Newman JM, Zhou JJ, Oommen AJ, Naziri Q, Shah NV, et al. Ankle Fracture Epidemiology in the United States: Patient-Related Trends and Mechanisms of Injury. J foot ankle Surg Off Publ Am Coll Foot Ankle Surg. 2020;59(3):479-83. doi: 10.1053/j.jfas.2019.09.016.

 

Benedick A, Audet MA, Vallier HA. The effect of obesity on post-operative complications and functional outcomes after surgical treatment of torsional ankle fracture: A matched cohort study. Injury. 2020;51(8):1893-8. doi: 10.1016/j. injury.2020.05.006.

 

Heyer JH, Perim DA, Amdur RL, Pandarinath R. Impact of smoking on outcomes following knee and shoulder arthroscopy. Eur J Orthop Surg Traumatol. 2020;30(2):329-36. doi: 10.1007/s00590-019-02577-2.

 

Arif GUL, Batra S, Mehmood S, Gillham N. Immediate unprotected weight-bearing of operatively treated ankle fractures. Acta Orthop Belg. 2007;73(3):360-5.

 

Dehghan N, McKee MD, Jenkinson RJ, Schemitsch EH, Stas V, Nauth A, et al. Early weightbearing and range of motion versus non-weightbearing and immobilization after open reduction and internal fixation of unstable ankle fractures: A randomized controlled trial. J Orthop Trauma. 2016;30(7):345-52. doi: 10.1097/BOT.0000000000000572.

 

Vieira Cardoso D, Dubois-Ferrière V, Gamulin A, Baréa C, Rodriguez P, Hannouche D, et al. Operatively treated ankle fractures in Switzerland, 2002-2012: epidemiology and associations between baseline characteristics and fracture types. BMC Musculoskelet Disord. 2021;22(1):266. doi: 10.1186/ s12891-021-04144-5.

 

Scott LJ, Jones T, Whitehouse MR, Robinson PW, Hollingworth W. Exploring trends in admissions and treatment for ankle fractures: a longitudinal cohort study of routinely collected hospital data in England. BMC Health Serv Res. 2020;20(1):811. doi: 10.1186/s12913-020-05682-9.

 

Elsoe R, Ostgaard SE, Larsen P. Population-based epidemiology of 9767 ankle fractures. Foot ankle Surg Off J Eur Soc Foot Ankle Surg. 2018;24(1):34-9. doi: 10.1016/j.fas.2016.11.002.

 

Beerekamp MSH, de Muinck Keizer RJO, Schep NWL, Ubbink DT, Panneman MJM, Goslings JC. Epidemiology of extremity fractures in the Netherlands. Injury. 2017;48(7):1355-62. doi: 10.1016/j.injury.2017.04.047.

 

Stavem K, Naumann MG, Sigurdsen U, Utvåg SE. Association of Body Mass Index With the Pattern of Surgically Treated Ankle Fractures Using Two Different Classification Systems. J foot ankle Surg Off Publ Am Coll Foot Ankle Surg. 2017;56 (2):314-8. doi: 10.1053/j.jfas.2016.10.008.

 

Beckenkamp PR, Lin C-WC, Chagpar S, Herbert RD, van der Ploeg HP, Moseley AM. Prognosis of physical function following ankle fracture: a systematic review with meta-analysis. J Orthop Sports Phys Ther. 2014;44(11):841-51, B2. doi: 10.2519/ jospt.2014.5199.

 

Sanders DW, Tieszer C, Corbett B. Operative versus nonoperative treatment of unstable lateral malleolar fractures: a randomized multicenter trial. J Orthop Trauma. 2012;26(3):129- 34. doi: 10.1097/BOT.0b013e3182460837.

 

Mittal R, Harris IA, Adie S, Naylor JM. Surgery for Type B Ankle Fracture Treatment: a Combined Randomised and Observational Study (CROSSBAT). BMJ Open. 2017;7(3):e013298. doi: 10.1136/bmjopen-2016-013298.

 

Keene DJ, Mistry D, Nam J, Tutton E, Handley R, Morgan L, et al. The Ankle Injury Management (AIM) trial: a pragmatic, multicentre, equivalence randomised controlled trial and economic evaluation comparing close contact casting with open surgical reduction and internal fixation in the treatment of unstable ankle fract. Health Technol Assess. 2016;20(75):1-158. doi: 10.3310/hta20750.

 

Willett K, Keene DJ, Mistry D, Nam J, Tutton E, Handley R, et al. Close Contact Casting vs Surgery for Initial Treatment of Unstable Ankle Fractures in Older Adults: A Randomized Clinical Trial. JAMA. 2016;316(14):1455-63. doi: 10.1001/jama.2016.14719.

 

Won SH, Chung CY, Park MS, Lee SY, Suh YS, Lee KM. Characteristics of and Factors Contributing to Immediate Postoperative Pain After Ankle Fracture Surgery. J foot ankle Surg Off Publ Am Coll Foot Ankle Surg. 2018;57(5):890-3. doi: 10.1053/j.jfas.2018.03.008.

 

Keene DJ, Vadher K, Willett K, Mistry D, Costa ML, Collins GS, et al. Predicting patient-reported and objectively measured functional outcome 6 months after ankle fracture in people aged 60 years or over in the UK: prognostic model development and internal validation. BMJ Open. 2019 Jul;9(7):e029813. doi: 10.1136/bmjopen-2019-029813.

 

Lin C-WC, Moseley AM, Herbert RD, Refshauge KM. Pain and dorsiflexion range of motion predict short- and medium-term activity limitation in people receiving physiotherapy intervention after ankle fracture: an observational study. Aust J Physiother. 2009;55(1):31-7. doi: 10.1016/s0004-9514(09)70058-3

 

Hancock MJ, Herbert RD, Stewart M. Prediction of outcome after ankle fracture. J Orthop Sports Phys Ther. 2005;35(12): 786–92. doi: 10.2519/jospt.2005.35.12.786.

 

Goost H, Wimmer MD, Barg A, Kabir K, Valderrabano V, Burger C. Fractures of the Ankle Joint Investigation and Treatment Options. Dtsch Arztebl Int. 2014;111(21):377-88. doi: 10.3238/ arztebl.2014.0377.


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