Jay Richard M, Malay D Scot, Landsman Adam S, Jennato Nathan, Huish James, Younger Melissa
Surgeon, Pennsylvania Hospital, Philadelphia, PA.
Staff Surgeon and Director of Podiatric Research, Penn Presbyterian Medical Center, Philadelphia, PA.
J Foot Ankle Surg. 2016 Jul-Aug;55(4):697-708. doi: 10.1053/j.jfas.2016.03.017. Epub 2016 May 11.
We undertook a multicenter, parallel treatment arm, randomized controlled trial to compare the outcomes after surgery for the treatment of lesser digital hammertoe using either a Kirschner wire or a 2-piece intramedullary, stainless steel implant for fixation of the proximal interphalangeal joint. Our primary aim was to compare the incidence of arthrodesis and complications, and our secondary aim was to compare the subjective foot-related outcomes measured using the Bristol Foot Score and the Foot Function Index, stratified by fixation group. We hypothesized that the use of the dual-component implant would result in greater patient satisfaction, a greater incidence of radiographic arthrodesis, and fewer complications after hammertoe repair. The overall mean age of the participants was 58.72 ± 13.48 (range 18 to 84) years, their mean body mass index was 30.14 ± 6.55 (range 20.7 to 46.98) kg/m(2), and no statistically significant differences in the demographic variables were present between the treatment groups at baseline or during the follow-up period. Of the 91 participants, 46 (50.55%) were randomly allocated to the Kirschner wire group and 45 (49.45%) to the intramedullary implant group. No statistically significant differences were observed between the 2 fixation groups in the incidence of complications; however, the 2-piece intramedullary implant group was associated with a greater mean Bristol Foot Score and Foot Function Index score and a greater incidence of fusion.
我们开展了一项多中心、平行治疗组、随机对照试验，以比较使用克氏针或两件式髓内不锈钢植入物固定近侧指间关节治疗小趾锤状趾手术后的结果。我们的主要目的是比较关节融合术的发生率和并发症，次要目的是比较使用布里斯托尔足部评分和足部功能指数测量的与足部相关的主观结果，并按固定组进行分层。我们假设使用双组件植入物将使患者满意度更高、影像学关节融合术的发生率更高，且锤状趾修复后的并发症更少。参与者的总体平均年龄为58.72±13.48（范围18至84）岁，平均体重指数为30.14±6.55（范围20.7至46.98）kg/m²，在基线或随访期间，各治疗组之间的人口统计学变量无统计学显著差异。在91名参与者中，46名（50.55%）被随机分配至克氏针组，45名（49.45%）被分配至髓内植入物组。两组固定方式在并发症发生率方面未观察到统计学显著差异；然而，两件式髓内植入物组的布里斯托尔足部评分和足部功能指数评分更高，融合发生率也更高。
