Multi-disciplinary treatment combined with enhanced recovery after surgery for elderly patients with osteoporotic ankle fracture
10.3760/cma.j.cn115530-20241030-00424
- VernacularTitle:多学科诊疗加速康复外科模式在老年骨质疏松性踝关节骨折治疗中的应用
- Author:
Tianyi WU
1
;
Chenglin WU
1
;
Yixuan CHEN
1
;
Chang LIU
1
;
Mingjie TANG
1
;
Ting WANG
1
;
Lei WANG
1
;
Zhongmin SHI
1
;
Xin MA
1
Author Information
1. 上海交通大学医学院附属第六人民医院骨科，上海 200233
- Publication Type:Journal Article
- Keywords:
Fractures, bone;
Recovery;
Osteoporosis;
Multidisciplinary diagnosis and treatment model;
Propensity score matching;
Therapeutic effect
- From:
Chinese Journal of Orthopaedic Trauma
2025;27(1):57-63
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the clinical value of multi-disciplinary treatment (MDT) combined with enhanced recovery after surgery (ERAS) for the elderly patients with osteoporotic ankle fracture.Methods:A retrospective analysis was conducted to analyze the 88 elderly patients with osteoporotic ankle fracture who had been treated with MDT combined with ERAS or non-MDT at Department of Foot and Ankle Surgery, Shanghai Sixth People's Hospital from January 2021 to January 2024. According to whether MDT was adopted or not, this cohort was assigned into 2 groups using the propensity score matching method: a MDT group and a non-MDT group with a matching ratio of 1∶1 (44 cases per group). The 2 groups were compared in terms of choice of intraoperative fixation, hospital stay, time for return to work/daily life, patient satisfaction questionnaire (PSQ-18) during hospitalization, ankle range of motion at 1 and 3 months after surgery, ankle-hindfoot score of American Orthopaedic Foot and Ankle Society (AOFAS), visual analogue scale (VAS) for pain, gait, and incidence of complications.Results:There were no significant differences in the preoperative general data between the 2 groups, indicating comparability ( P<0.05). The choice of intraoperative fixation, PSQ-18 [(78.4±8.5) points], AOFAS ankle-hindfoot score at 3 months after operation [(75.4±8.2) points], and gait in the MDT group were significantly better than those in the non-MDT group [(74.2±9.6) points and (70.9±9.4) points] ( P<0.05). There was no significant difference in the hospital stay or time for return to work/daily life between the 2 groups ( P>0.05). There was no statistically significant difference either in ankle dorsiflexion or plantarflexion, VAS for pain, or incidence of complications between the 2 groups at 1 or 3 months after surgery, as well as in AOFAS ankle-hindfoot score or gait at 1 month after surgery ( P>0.05). Conclusion:MDT combined with ERAS can effectively increase the therapeutic efficacy for the elderly patients with osteoporotic ankle fracture, improve their function of affected limbs, and enhance their patient satisfaction.
