Department of Orthopaedics, University of Rochester Medical Center, Rochester, NY 14642, USA.
Foot Ankle Int. 2010 Mar;31(3):197-202. doi: 10.3113/FAI.2010.0197.
The influence of demographic, medical history, and treatment variables on the maintenance of nonoperative care or progression to operative intervention in Posterior Tibial Tendon Dysfunction (PTTD) was explored. This retrospective study compared demographic, medical history and treatment variables between operative and nonoperative care in subjects with PTTD.
Charts with the ICD-9 codes (726.72, 726.90) and brace distribution records for 2005 and 2006 were used to identify subjects. From these, 166 of 606 charts included documentation of PTTD. Variables were grouped into three categories including demographics (Age, body mass index, gender and working status), medical (stage, symptom duration, pain at initial evaluation, and past treatments) and treatment (initial brace, length of care episode, and brace change). Statistical comparisons between subjects treated nonoperatively and operatively were made. Significant variables were entered into a logistic regression analysis. Accuracy (sensitivity/specificity) was assessed by examining the success of predicting which subjects were treated operatively or nonoperatively.
Of the 166 subjects, 125 (75.4%) received nonoperative care and 41 (24.6%) operative care. Nine variables distinguished the operative from the nonoperative group (p<0.05): including BMI, work status, stage, symptom duration, prior orthotic use, prior injection, custom brace, brace changes, and length of care episode. The logistic regression model identified BMI, symptom duration, prior cortisone injections, and prior orthotic use as significant and resulted in a specificity of 95.4% and sensitivity of 38.2%.
This retrospective analysis provides a patient profile of factors in the success of nonoperative care in PTTD.
探讨了人口统计学、病史和治疗变量对维持非手术治疗或进展为手术干预的后胫后肌腱功能障碍（PTTD）的影响。本回顾性研究比较了 PTTD 患者手术和非手术治疗的人口统计学、病史和治疗变量。
使用 ICD-9 编码（726.72、726.90）和支具分布记录，对 2005 年和 2006 年的图表进行了研究，以确定患者。从这些图表中，有 166 份图表记录了 PTTD 的资料。将变量分为三组，包括人口统计学（年龄、体重指数、性别和工作状态）、医学（分期、症状持续时间、初次评估时的疼痛和既往治疗）和治疗（初始支具、护理时间和支具更换）。对非手术和手术治疗的患者进行了统计学比较。将有意义的变量纳入逻辑回归分析。通过检查预测哪些患者接受手术或非手术治疗的成功率，评估准确性（敏感性/特异性）。
在 166 名患者中，125 名（75.4%）接受了非手术治疗，41 名（24.6%）接受了手术治疗。有 9 个变量区分了手术组和非手术组（p<0.05）：包括 BMI、工作状态、分期、症状持续时间、既往矫形器使用、既往注射、定制支具、支具更换和护理时间。逻辑回归模型确定 BMI、症状持续时间、既往皮质激素注射和既往矫形器使用为显著因素，特异性为 95.4%，敏感性为 38.2%。
本回顾性分析提供了 PTTD 非手术治疗成功的患者特征因素。
