Predictive value of clinical scoring and simplified gait analysis for acetabulum fractures

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• 作者：Benedikt J. Braun ; MD ; ^{benedikt.braun@uks.eu" class="auth_mail" title="E-mail the corresponding author} ; Julian Wrona ; Nils T. Veith ; MD ; Mika Rollman ; MD ; Marcel Orth ; MD ; Steven C. Herath ; MD ; Jö ; rg H. Holstein ; MD ; Tim Pohlemann ; MD
• 关键词：Clinical scoring ; Gait analysis ; Acetabular fracture
• 刊名：Journal of Surgical Research
• 出版年：2016
• 出版时间：December 2016
• 年：2016
• 卷：206
• 期：2
• 页码：405-410
• 全文大小：249 K

文摘

Fractures of the acetabulum show a high, long-term complication rate. The aim of the present study was to determine the predictive value of clinical scoring and standardized, simplified gait analysis on the outcome after these fractures.

Methods

Forty-one patients with acetabular fractures treated between 2008 and 2013 and available, standardized video recorded aftercare were identified from a prospective database. A visual gait score was used to determine the patients walking abilities 6-m postoperatively. Clinical (Merle d'Aubigne and Postel score, visual analogue scale pain, EQ5d) and radiological scoring (Kellgren–Lawrence score, postoperative computed tomography, and Matta classification) were used to perform correlation and multivariate regression analysis.

Results

The average patient age was 48 y (range, 15-82 y), six female patients were included in the study. Mean follow-up was 1.6 y (range, 1-2 y). Moderate correlation between the gait score and outcome (versus EQ5d: r_s = 0.477; versus Merle d'Aubigne: r_s = 0.444; versus Kellgren–Lawrence: r_s = −0.533), as well as high correlation between the Merle d'Aubigne score and outcome were seen (versus EQ5d: r_s = 0.575; versus Merle d'Aubigne: r_s = 0.776; versus Kellgren–Lawrence: r_s = −0.419). Using a multivariate regression model, the 6 m gait score (B = −0.299; P < 0.05) and early osteoarthritis development (B = 1.026; P < 0.05) were determined as predictors of final osteoarthritis. A good fit of the regression model was seen (R² = 904).

Conclusions

Easy and available clinical scoring (gait score/Merle d'Aubigne) can predict short-term radiological and functional outcome after acetabular fractures with sufficient accuracy. Decisions on further treatment and interventions could be based on simplified gait analysis.