Aparicio AM, Cassis ZN, Torres-Gómez A

Language: Spanish
References: 15
Page: 20-27
PDF size: 88.82 Kb.

ABSTRACT

Objective: To know the outcome of patients presenting angular ankle deformitiesand post-operated through supramalleolar osteotomy, according to physical functioning and life quality. Material and Methods: This was a cohortlongitudinal study from consecutive patients (15 patients, 20 ankles) post-operated for supramalleolar osteotomy at the Shriners Hospital for Children in Mexico City during the period going from January 2002 to June 2008. The clinical function was measured through the AOFAS, scale and life quality by means of the SF-36. The patients’ global function was assessed through the PODCI scale. Descriptive statistics was used for every variable, and the continuous variables were subjected to normality tests in order to choose the proper type of analysis. The hypothesis tests were carried out with the two-tailedMann–Whitney U test. The analysis were performed by means of grouping the patients in three different ways: according to the correction (± 6° of physiological deviation), etiology (dysplasia of bone), and the Body Mass Index (BMI). The average for the corrected patients (8) was of17.6 years old (± 1.75), the non-corrected patients (12) had an average age of 13.17 years old (± 3.09). The corrected patients presented an AOFAS median of 91.5 points (78-98), with an IQR of 8. The non-corrected patients had a median of 77.5 points (66-97), with an IQR of 20. Results: With regard to the total SF-36 total, the corrected patients obtained a median of 81.66 (IQR = 9.85), and the non-corrected patients had a median of 83.19 points (IQR = 15.33;p = 0.91). There were no significant statistical differences regarding the PODCI, both the reported by the patients and the informed by the parents with regard to global functioning. According to the etiologies, and referred to a totalSF-36, in patients with dysplasia of bones, the median was of 77.69 points (IQR = 16.12), the patients presenting other etiologies had a median of 87.77 points (IQR = 6.95; p = 0.001). The results from the PODCI for the group of dysplasia of bone presented a median of 42 points (IQR = 30.5). For the group with other etiologies, the median was of 55 points (IQR = 6; p = 0.047). There were no significant statistical differences for the PODCI reported by the parents. With regard to life quality, the patients with a BMI‹ 25 kg/m² presented an SF-36 median of 77.87 points (IQR = 9.03). The group with a BMI ≥ 25 kg/m² presented a median of 88.05 points (IQR = 8.75; p = 0.012). No significant differences were observed among the PODCI reported scores. Discussion: The patients subjected to supramalleolar osteotomy that were not corrected did not show differences either with regard to life quality assessed by the SF-36 or in the global functioning evaluated through the PODCI when compared with the corrected patients. Those patients who presented dysplasia of bone had a lesser score in comparison with the patients who presented other etiologies, both in the SF-36 and in the PODCI reported by the patients. The patients presenting a BMI ≥ 25 kg/m² demonstrated a better life quality than those patients without overweight. The global functioning, however, did not show differences in the PODCI scores. Conclusion: The patients treated for supramalleolar osteotomies showed a life quality over the average of 50, regardless the correction state, the etiology or the overweight. Nevertheless, the patients with dysplasia of bone showed a lesser life quality and a decreased global physical functioning. The aforementioned fact must be taken into account at the moment of treating those patients.

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