GIKK Ortho Specialists, Omaha, NE 68124, USA.
Foot Ankle Int. 2010 Sep;31(9):760-9. doi: 10.3113/FAI.2010.0760.
The management of adult acquired flatfoot is an evolving practice with the optimal lateral column lengthening procedure still left to considerable debate. The usual choices include lengthening with the use of autograft or allograft through a calcaneocuboid lengthening arthrodesis or Evans' calcaneal lengthening osteotomy. To our knowledge there is only one other study comparing autograft to allograft in adult lateral column lengthening procedures.(9) The purpose of this study was to evaluate differences with regard to union rates and complications when comparing the use of iliac tricortical autograft versus iliac tricortical allograft supplemented with platelet rich plasma (PRP) in adult acquired flatfoot lateral column lengthening procedures.
The charts and radiographs of 49 patients (51 feet) were evaluated. Twenty total procedures were performed using iliac tricortical autograft and 31 procedures were performed using iliac tricortical allograft with PRP.
Successful union was achieved in 14 of 20 (70%) autograft procedures and 29 of 31 (94%) allograft procedures. Thirteen of 20 (65%) of the autograft group and 11 of 31 (35%) of the allograft group had a documented complication other than nonunion. Average length of hospital stay for patients who had procedures using autograft was 3.6 days and those who had allograft was 2.5 days. The average charge for those receiving allograft with PRP, including hospital stay, was roughly $2,500 more than those receiving an autograft procedure.
Although the numbers were small, we believe that equivalent if not better healing and complication rates are possible with the use of allograft with PRP versus autograft for lateral column lengthening procedures while allowing for similar correction of deformity.
成人获得性扁平足的治疗是一个不断发展的实践领域，最佳的外侧柱延长术式仍存在较大争议。通常的选择包括通过跟距骨延长融合术或 Evans 跟骨延长截骨术，使用自体或同种异体骨进行延长。据我们所知，只有另一项研究比较了成人外侧柱延长术中自体骨与同种异体骨的应用。（9）本研究旨在评估在成人获得性扁平足外侧柱延长术中，比较使用髂骨三叶皮质自体骨与补充富血小板血浆（PRP）的同种异体三叶皮质骨在愈合率和并发症方面的差异。
评估了 49 例患者（51 足）的病历和 X 线片。20 例手术采用髂骨三叶皮质自体骨，31 例手术采用髂骨三叶皮质同种异体骨加 PRP。
20 例自体骨组中，14 例（70%）成功愈合，31 例同种异体骨加 PRP 组中，29 例（94%）成功愈合。20 例自体骨组中，13 例（65%）有并发症，而非骨不连，31 例同种异体骨加 PRP 组中，11 例（35%）有并发症。自体骨组患者的平均住院时间为 3.6 天，同种异体骨加 PRP 组为 2.5 天。接受同种异体骨加 PRP 治疗的患者平均费用比接受自体骨手术治疗的患者高出约 2500 美元。
尽管数量较少，但我们认为，在外侧柱延长术式中，同种异体骨加 PRP 的应用可能具有等效甚至更好的愈合率和并发症发生率，同时可实现相似的畸形矫正。
