Farhadi Jian, Valderrabano Victor, Kunz Christoph, Kern Reinhard, Hinterman Beat, Pierer Gerhard
Department of Reconstructive Surgery, University Hospital Basel, Basel, Switzerland.
Ann Plast Surg. 2007 Apr;58(4):405-10. doi: 10.1097/01.sap.0000241948.36784.4e.
The aim of this study was the quantitative assessment of donor-site morbidity after fibula harvest. Ten patients were identified with a unilateral fibula harvesting and healthy contralateral side. The average follow-up time was 32.3 months. The study design included standardized questionnaire; morbidity point-evaluation system; orthopedic-biomechanical evaluation, including true ankle motion, clinical-functional American Orthopedic Foot and Ankle Society (AOFAS) hindfoot score, pedobarography, measurement of maximal voluntary isometric strength, and radiologic examination using an ankle osteoarthritis grading. Average donor-side morbidity score was low, with 2.6 points (range, 0 to 13). Average AOFAS hindfoot score was good, with 87.3 points (range, 74 to 100). Pedobarography showed significant decrease of the big toe pushup force. Isometric strength measurement showed significant reduction of the peroneus longus muscle. Discrete to mild medial ankle osteoarthritis was found in 70% of the cases. The overall donor-side morbidity was low, but an eversion torque deficit could initiate or support a progressive functional ankle instability and in long-term cause or accelerate a ligamentous secondary ankle osteoarthritis.
本研究的目的是对腓骨取骨后供区并发症进行定量评估。确定了10例进行单侧腓骨取骨且对侧健康的患者。平均随访时间为32.3个月。研究设计包括标准化问卷、并发症评分评估系统、骨科生物力学评估，包括真踝关节活动度、美国矫形足踝协会（AOFAS）后足临床功能评分、足底压力测定、最大自主等长肌力测量以及使用踝关节骨关节炎分级的放射学检查。供区平均并发症评分为2.6分（范围为0至13分），较低。AOFAS后足平均评分为87.3分（范围为74至100分），较好。足底压力测定显示拇趾上推力显著降低。等长肌力测量显示腓骨长肌力量显著下降。70%的病例发现有离散至轻度的内踝骨关节炎。供区总体并发症较低，但外翻扭矩不足可能引发或加重进行性功能性踝关节不稳，并在长期导致或加速继发性踝关节韧带性骨关节炎。
