Is Psychiatric Illness Associated With Worse Outcomes Following Pilon Fracture?

Q3 Medicine The Iowa orthopaedic journal Pub Date : 2022-06-01

Kevin Rezzadeh, Bo Zhang, Diana Zhu, Mark Cubberly, Hayk Stepanyan, Babar Shafiq, Phillip Lim, Ranjan Gupta, Jacques Hacquebord, Kenneth Egol

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引用次数: 0

Abstract

Background: Patients with psychiatric comorbidities represent a significant subset of those sustaining pilon fractures. The purpose of this study is to examine the association of psychiatric comorbidities (PC) in patients with pilon fractures and clinical outcomes.

Methods: A multi-institution, retrospective review was conducted. Inclusion/exclusion criteria were skeletally mature patients with a tibia pilon fracture (OTA Type 43B/C) who underwent definitive fracture fixation utilizing open reduction internal fixation (ORIF) with a minimum of 24 weeks of follow-up. Patients were stratified into two groups for comparison: PC group and no PC group.

Results: There were 103 patients with pilon fractures that met the inclusion/exclusion criteria of this study. Of these patients, 22 (21.4%) had at least one psychiatric comorbidity (PC) and 81 (78.6%) did not have psychiatric comorbidities (no PC). There was a higher percentage of female patients (PC: 59.1% vs no PC: 25.9%, p=0.0.005), smokers (PC: 40.9% vs no PC: 16.0%, p=0.02), and drug users (PC: 22.7% vs no PC: 8.6%, p=0.08) amongst PC patients. Fracture comminution (PC: 54.5% vs no PC: 32.1%, p=0.05) occurred more frequently in PC patients. The PC group had a higher incidence of weightbearing noncompliance (22.7% vs 7.5%, p=0.04) and reoperation (PC: 54.5% vs no PC: 29.6%, p=0.03).

Conclusion: Patients with psychiatric comorbidities represent a significant percentage of pilon fracture patients and appear to be at higher risk for postoperative complication. Risk factors that may predispose patients in the PC group include smoking/substance use, weightbearing noncompliance, and fracture comminution. Level of Evidence: III.

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皮隆骨折后精神疾病是否与不良预后相关?

背景:伴有精神合并症的患者是持续性枕部骨折患者的重要组成部分。本研究的目的是探讨头枕骨折患者精神合并症(PC)与临床预后的关系。方法:采用多机构回顾性研究。纳入/排除标准是骨骼成熟的胫骨pilon骨折患者(OTA型43B/C)，采用开放复位内固定(ORIF)进行明确骨折固定，随访至少24周。将患者分为两组进行比较:PC组和无PC组。结果:103例头枕骨折患者符合本研究的纳入/排除标准。在这些患者中，22例(21.4%)至少有一种精神合并症(PC)， 81例(78.6%)没有精神合并症(无PC)。PC患者中女性患者(PC: 59.1% vs无PC: 25.9%， p=0.0.005)、吸烟者(PC: 40.9% vs无PC: 16.0%， p=0.02)和吸毒者(PC: 22.7% vs无PC: 8.6%， p=0.08)的比例较高。骨折粉碎(有骨裂:54.5% vs无骨裂:32.1%，p=0.05)在有骨裂患者中发生率更高。PC组不遵负重发生率(22.7% vs 7.5%， p=0.04)和再手术发生率(PC组:54.5% vs无PC组:29.6%，p=0.03)较高。结论:伴有精神合并症的患者在枕部骨折患者中占很大比例，并且出现术后并发症的风险更高。可能使PC组患者易感的危险因素包括吸烟/物质使用、不服从负重和骨折粉碎。证据水平:III。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

The Iowa orthopaedic journal Medicine-Medicine (all)

CiteScore

1.50

自引率

0.00%

发文量

期刊介绍： Any original article relevant to orthopaedic surgery, orthopaedic science or the teaching of either will be considered for publication in The Iowa Orthopaedic Journal. Articles will be enthusiastically received from alumni, visitors to the department, members of the Iowa Orthopaedic Society, residents, and friends of The University of Iowa Department of Orthopaedics and Rehabilitation. The journal is published every June.