Multivariate analysis of influencing functional recovery after ankle fracture of typeⅡand above supination-external rotation

Abstract

To explore influencing factors of functional recovery after ankle fracture of typeⅡdegree and above supination-external rotation. Clinical data of 120 patients with ankle fractures of typeⅡdegree and above supination-external rotation admitted from February 2019 to April 2021 were retrospectively analyzed. According to American Orthopaedic Foot and Ankle Society (AOFAS), patients were divided into excellent group with 73 patients (90 to 100 points), good group with 35 patients (75 to 89 points), and fair group with 12 patients(<50 points). The differences of ankle active range of motion (ROM) and AOFAS score were compared among three groups at the latest follow-up. Multivariate Logistic regression analysis was performed to analyze the factors related to functional recovery after ankle fracture of supination-external rotation. There were significant differences in postoperative ROM (dorsoextension, plantar flexion, varus and valgus) and complications between excellent group and good and acceptable group (P<0.05). Univariate analysis showed there were differences in age above 50 years old, Ⅳ degree of supination-external rotation fracture, lower tibiofibular ligament injury, posterior ankle fracture, no drainage tube placed, infection, antibiotic use time above 7 days (P<0.05). Multivariate Logistic regression analysis showed age above 50 years old[OR=2.829, 95%CI(1.049, 7.628), P=0.040], Ⅳ degree fracture of supination-external rotation[OR=6.13, 95%CI(1.153, 32.593), P=0.033], lower tibiofibular ligament injury[OR=10.785, 95%CI(3.338, 34.894), P=0.000], and posterior ankle fracture[OR=6.349, 95%CI(1.869, 21.560), P=0.003] were independent risk factors for functional recovery after ankle fracture of supination-external rotation (P<0.05). The postoperative excellent outcome of ankle fracture was good, and the recovery of joint motion was better. The older age of patient, Ⅳ degree of supination-external rotation fracture, the lower tibiofibular ligament injury, and posterior ankle fracture are all adverse factors affecting functional recovery after supination-external rotation ankle fracture. In clinical, effective measures should be taken to deal with these influencing factors, and strive to improve the functional recovery after the operation of this type of fracture and reduce the occurrence of related complications.