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开放自体骨移植距下关节融合术与门诊关节镜下使用可注射骨形态发生蛋白增强移植物的距下关节融合术的比较

Comparison of open isolated subtalar arthrodesis with autogenous bone graft versus outpatient arthroscopic subtalar arthrodesis using injectable bone morphogenic protein-enhanced graft.

作者信息

Scranton P E

机构信息

Orthopedics International, LTD, P.S., Seattle, Washington, USA.

出版信息

Foot Ankle Int. 1999 Mar;20(3):162-5. doi: 10.1177/107110079902000304.

Abstract

Isolated subtalar joint arthrodesis is an established salvage procedure that can be performed in various ways for varying diagnoses. The purpose of this article is to report a new arthroscopic subtalar arthrodesis technique that has been developed. The results of this method versus an open technique were compared. Length of hospital stay, tourniquet time, morbidity, and fusion rate were studied in 17 fusion patients between 1990 and 1997. Twelve patients had open arthrodesis with bone graft and 5 patients had arthroscopic arthrodesis with supplemental, injectable, osteoinductive enhanced-graft gel. The length of stay decreased 1.7 days with the arthroscopic procedure. Tourniquet time was not significantly different. One open procedure required refusion, whereas none did in the arthroscopic group. One patient in each group required AO screw removal. In selected patients with subtalar arthrosis without significant hindfoot deformity, arthroscopic arthrodesis can be an effective. It is too early to determine if there are specific advantages in this procedure compared with a conventional open arthrodesis.

摘要

单纯距下关节融合术是一种成熟的挽救性手术,可根据不同诊断以多种方式进行。本文旨在报告一种新开发的关节镜下距下关节融合技术。将该方法与开放技术的结果进行了比较。对1990年至1997年间17例融合患者的住院时间、止血带使用时间、发病率和融合率进行了研究。12例患者采用开放植骨融合术,5例患者采用关节镜下融合术并使用补充性、可注射的骨诱导增强移植凝胶。关节镜手术使住院时间缩短了1.7天。止血带使用时间无显著差异。1例开放手术需要再次融合,而关节镜组无此情况。每组各有1例患者需要取出AO螺钉。对于选定的无明显后足畸形的距下关节病患者,关节镜下融合术可能是有效的。与传统开放融合术相比,该手术是否具有特定优势尚有待确定。

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