Department of Orthopaedics, University of Szeged, 6 Semmelweis str., Szeged, Hungary.
Arch Orthop Trauma Surg. 2010 Oct;130(10):1257-61. doi: 10.1007/s00402-009-1024-4. Epub 2010 Jan 5.
The Akin osteotomy is a widely used procedure where various fixation methods are available, predominantly with the use of metallic component (wire, screw, staple etc.). The aim of this study is to demonstrate the results of our modified Akin procedures, where the fixation of the phalangeal osteotomy is achieved by absorbable suture, without metallic component.
Between July 2004 and October 2008, authors performed their first 22 consecutive Akin procedures with the above technique. Mean age of patients was 49 [standard deviation (SD) 17, range 19-69] years. Mean follow-up time was 26 (SD 13, range 8-57) months.
Mean correction of the distal articular set angle (DASA) was 9.4 (SD 7.1, range 5-28) degrees. Mean shortening of the proximal phalanx was 1.8 (SD 1.0, range 0.3-4.1) mm. Among the 22 osteotomies, there was no evidence of non-union, delayed union, excessive bone callus, or loss of correction. 100% of the patients would undergo the procedure again, 91% (20/22) were completely satisfied; and 9% (2/22) were satisfied, including the one complication case.
The method presented in this study for fixation of the akin osteotomy showed results identical to the ones using conventional (metal) fixation techniques concerning radiological (correction of DASA, shortening of the proximal phalanx), and clinical (complication rate, subjective satisfaction rate) findings, without the risk of complication due to hardware irritation.
Akin 截骨术是一种广泛应用的手术方法,有多种固定方式可供选择,主要是使用金属部件(线、螺钉、钉书钉等)。本研究旨在展示我们改良的 Akin 手术方法的结果,其中通过可吸收缝线而不是金属部件来固定指骨截骨术。
2004 年 7 月至 2008 年 10 月,作者采用上述技术对 22 例连续 Akin 手术患者进行了治疗。患者平均年龄为 49 岁(标准差 17 岁,范围 19-69 岁)。平均随访时间为 26 个月(标准差 13 个月,范围 8-57 个月)。
远端关节面角(DASA)的平均矫正度为 9.4 度(标准差 7.1 度,范围 5-28 度)。近节指骨的平均缩短长度为 1.8 毫米(标准差 1.0 毫米,范围 0.3-4.1 毫米)。在 22 例截骨术中,无骨不连、延迟愈合、骨痂过多或矫正丢失的证据。100%的患者会再次接受该手术,91%(20/22)的患者完全满意,9%(2/22)的患者满意,包括 1 例并发症患者。
本研究中用于固定 Akin 截骨术的方法在影像学(DASA 矫正、近节指骨缩短)和临床(并发症发生率、主观满意度)方面与使用传统(金属)固定技术的结果相同,且不存在因金属刺激引起并发症的风险。