gms | German Medical Science

Deutscher Kongress für Orthopädie und Unfallchirurgie
74. Jahrestagung der Deutschen Gesellschaft für Unfallchirurgie
96. Tagung der Deutschen Gesellschaft für Orthopädie und Orthopädische Chirurgie
51. Tagung des Berufsverbandes der Fachärzte für Orthopädie und Unfallchirurgie

26. - 29.10.2010, Berlin

Long-Term Functional Outcome of Midfoot Fractures

Meeting Abstract

  • C. Jones - Orthopaedic Associates of Michigan, Michigan State University, College of Human Medicine, Department of Surgery, Grand Rapids, Michigan, United States
  • D. Sietsema - Orthopaedic Associates of Michigan, Michigan State University, College of Human Medicine, Department of Surgery, Grand Rapids, Michigan, United States
  • J. Ringler - Orthopaedic Associates of Michigan, Michigan State University, College of Human Medicine, Department of Surgery, Grand Rapids, Michigan, United States
  • T. Endres - Orthopaedic Associates of Michigan, Michigan State University, College of Human Medicine, Department of Surgery, Grand Rapids, Michigan, United States
  • M. Coulibaly - Michigan State University, College of Human Medicine, Department of Surgery, Orthopaedic Research Fellowship, GRMERC, Grand Rapids, Michigan, United States

Deutscher Kongress für Orthopädie und Unfallchirurgie. 74. Jahrestagung der Deutschen Gesellschaft für Unfallchirurgie, 96. Tagung der Deutschen Gesellschaft für Orthopädie und Orthopädische Chirurgie, 51. Tagung des Berufsverbandes der Fachärzte für Orthopädie. Berlin, 26.-29.10.2010. Düsseldorf: German Medical Science GMS Publishing House; 2010. DocIN19-510

DOI: 10.3205/10dkou117, URN: urn:nbn:de:0183-10dkou1176

Veröffentlicht: 21. Oktober 2010

© 2010 Jones et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielfältigt, verbreitet und öffentlich zugänglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Objective: Midfoot fractures (MF) are uncommon. The purpose of this study was to evaluate functional outcome in patients treated for MF fractures.

Methods: A prospective analysis was undertaken on a cohort of patients diagnosed with MF between March 2002 and June 2007 at a Level I teaching trauma center. Out of a total of 129 patients 62 patients with 65 treated MF returned valid questionnaires. Primary outcome was to evaluate functional status (Foot Function Index [FFI] and Short Musculoskeletal Function Assessment [SMFA]).

Results and conclusions: Thirty-two males and 30 females had a mean age of 44±14 years (range 17–72) and BMI 28.0 (range 17.5–48.9). Mechanism of injury was 31 road accidents (MVA/MCA/ATV), 9 crush injuries, 9 low-energy falls, 9 twist, and 4 high-energy falls or sport-related injury. Survey follow-up time averaged 53±20 mo (range 23–93). Based on presence of cuboid and navicular fractures patients were grouped into lateral column injury (LAT, 26/65, 40.0%), medial column injury (MED, 19/65, 29.2%), or bicolumn injury (BIC, 20/65, 30.8%) groups. Average functional status scores were FFI 31.1, Daily 21.8, Emotional 31.5, Arm-Hand 6.8, Mobility 29.0, Dysfunction 23.0, and Bother 24.2. BIC performed significantly worse than MED for all functional scores except Arm-Hand (p<0.05) and worse than LAT in FFI (p=0.007). BIC related to inferior functional scores (FFI r=0.419; SFMA Daily r=0.389, Mobility r=0.362, and Dysfunction r=0.341) with significance at p<0.01. The inability to return to previous level of activity was related to inferior functional status (FFI r=–0.424, Daily r=–0.403, Mobility r=–0.404, Dysfunction r=–0.377) with significance at p<0.01. BMI independently contributed to inferior functional scores (FFI R2=0.265, Daily R2=0.405, Emotional R2=0.374, Mobility R2=0.491, Dysfunction R2=0.450, Bother R2=0.493) with significance at p<0.001.

Midfoot fractures are debilitating injuries that remain challenging for the orthopaedic surgeon. Bicolumn injuries of the foot had the worst long-term functional outcome. Increased BMI determined inferior functional status.