Calder J D, Hollingdale J P, Pearse M F
Department of Orthopaedics, Central Middlesex Hospital, London, England, UK.
J Bone Joint Surg Br. 1999 Jul;81(4):621-4. doi: 10.1302/0301-620x.81b4.9595.
We studied prospectively 30 patients who had a Mitchell's osteotomy secured by either a suture followed by immobilisation in a plaster boot for six weeks, or by a cortical screw with early mobilisation. The mean time for return to social activities after fixation by a screw was 2.9 weeks and to work 4.9 weeks, which was significantly earlier than those who had stabilisation by a suture (5.7 and 8.7 weeks, respectively; p < 0.001). Use of a screw also produced a higher degree of patient satisfaction at six weeks, and an earlier return to wearing normal footwear. The improvement in forefoot scores was significantly greater after fixation by a screw at six weeks (p = 0.036) and three months (p = 0.024). At one year, two screws had been removed because of pain at the site of the screw head. Internal fixation of Mitchell's osteotomy by a screw allows the safe early mobilisation of patients and reduces the time required for convalescence.
我们前瞻性地研究了30例接受米切尔截骨术的患者，这些患者分别通过缝线固定并在石膏靴中固定六周，或通过皮质螺钉固定并早期活动。螺钉固定后恢复社交活动的平均时间为2.9周，恢复工作的平均时间为4.9周，这明显早于通过缝线固定的患者（分别为5.7周和8.7周；p<0.001）。使用螺钉在六周时也产生了更高的患者满意度，并且更早恢复穿正常鞋子。六周（p = 0.036）和三个月（p = 0.024）时，螺钉固定后前足评分的改善明显更大。一年时，由于螺钉头部部位疼痛，两枚螺钉已被取出。通过螺钉对米切尔截骨术进行内固定可使患者安全地早期活动，并减少康复所需的时间。
