自体骨和同种异体骨在成人获得性扁平足畸形的外侧柱延长中结合方式相同。
Autograft and allograft unite similarly in lateral column lengthening for adult acquired flatfoot deformity.
机构信息
Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021 USA ; Columbia University, 622 West 168th Street, PH-11, New York, NY 10032 USA.
Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021 USA.
出版信息
HSS J. 2013 Feb;9(1):6-11. doi: 10.1007/s11420-012-9317-5. Epub 2013 Jan 10.
BACKGROUND
Lateral column lengthening (LCL) is used to address the forefoot abduction associated with the adult acquired flatfoot. This opening wedge osteotomy can be filled with either allograft or autograft bone.
QUESTIONS/PURPOSES: The investigators sought to determine union rates and any loss of correction in patients undergoing LCL with autograft versus allograft.
METHODS
Over a 3-year period, 126 LCLs performed by five surgeons in 120 patients were reviewed. Autograft was used in 51 patients, allograft in 75 patients. Times to clinical and radiographic union were established for these patients. Any loss of correction of forefoot abduction as manifested by talonavicular uncoverage was recorded for those grafts that healed. Failure was defined as nonunion or loss of 50% or greater correction. The size of the implanted graft was assessed as a risk factor for failure.
RESULTS
There were 20 total failures: seven in patients with autograft and 13 in patients with allograft (p = 0.63). The size of the implanted graft was larger in those patients that did fail (p = 0.04).
CONCLUSIONS
The rate of nonunion and loss of correction for LCL was not significantly different between allograft and autograft. The overall rate of nonunion may be higher than has previously been reported.
背景
外侧柱延长术（LCL）用于解决成人获得性平足症相关的前足外展。这种开放式楔形截骨术可以用同种异体骨或自体骨填充。
问题/目的：研究人员旨在确定自体移植物与同种异体移植物在 LCL 中使用的患者的融合率和任何矫正丢失。
方法
在 3 年期间，回顾了 5 位外科医生在 120 名患者中进行的 126 例 LCL。51 例患者使用自体移植物，75 例患者使用同种异体移植物。为这些患者确定了临床和影像学融合的时间。对于那些愈合的移植物，记录了前足外展矫正丢失的任何情况，表现为距舟骨显露。失败定义为不愈合或矫正丢失 50%或更多。植入移植物的大小被评估为失败的一个危险因素。
结果
共有 20 例总失败：自体移植物患者 7 例，同种异体移植物患者 13 例（p=0.63）。失败患者的植入移植物大小更大（p=0.04）。
结论
LCL 的非融合和矫正丢失率在同种异体骨和自体骨之间没有显著差异。非融合的总体发生率可能高于之前的报道。
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