Bresnahan Philip J, Chariton Joel T, Vedpathak Anuja
Indian Valley Podiatry Associates, PC, Souderton, PA, USA.
J Foot Ankle Surg. 2013 Mar-Apr;52(2):195-202. doi: 10.1053/j.jfas.2012.11.013. Epub 2013 Jan 11.
The present multicenter, prospective study evaluated the subjective outcomes in patients after extraosseous talotarsal stabilization using the HyProCure(®) stent as a standalone procedure for the treatment of recurrent and/or partial talotarsal joint dislocation (RTTD) in a population of pediatric and adult patients. RTTD has been cited as a possible etiology for a number of foot ailments and might contribute to the development of pathologic features localized more proximally in the weightbearing musculoskeletal chain. Correction of RTTD might, therefore, lead to the reduction of pathologic features associated with this deformity. A total of 46 feet in 35 patients were included in the present investigation. Subjective evaluation used the Maryland Foot Score assessment, which was obtained preoperatively and 1, 2, and 3 weeks, 1, 2, 3, and 6 months, and 1 year postoperatively. The mean overall scores improved from a preoperative value of 69.53 ± 19.56 to a postoperative value of 89.17 ± 14.41 at the 1-year follow-up. Foot pain decreased by 36.97%, foot functional activities improved by 14.39%, and foot appearance improved by 29.49%. The greatest magnitude of improvement occurred 4 weeks postoperatively, with gradual improvement continuing through to the 1-year follow-up. Implants were removed from 2 patients (2 feet, 4.35%). No unresolved complications were observed. The positive subjective outcomes resulting from the extraosseous talotarsal stabilization procedure suggest that the intervention employing the device we have described alleviates pain and improves foot function and appearance in patients with RTTD.
本多中心前瞻性研究评估了在儿科和成年患者群体中，使用HyProCure(®)支架作为独立手术进行跗骨间关节外稳定术治疗复发性和/或部分跗骨间关节脱位（RTTD）后患者的主观结果。RTTD被认为是多种足部疾病的可能病因，可能导致负重肌肉骨骼链近端局部病理特征的发展。因此，纠正RTTD可能会减少与此畸形相关的病理特征。本研究共纳入35例患者的46只脚。主观评估采用马里兰足部评分，在术前、术后1周、2周和3周、1个月、2个月、3个月和6个月以及1年时进行。在1年随访时，平均总分从术前的69.53±19.56提高到术后的89.17±14.41。足部疼痛减轻了36.97%，足部功能活动改善了14.39%，足部外观改善了29.49%。改善幅度最大发生在术后4周，直至1年随访时仍持续逐渐改善。2例患者（2只脚，4.35%）取出了植入物。未观察到未解决的并发症。跗骨间关节外稳定术产生的积极主观结果表明，我们所描述的使用该装置的干预措施可减轻RTTD患者的疼痛，改善足部功能和外观。
