Korim Muhammad Tawfiq, Mahadevan Devendra, Ghosh Arijit, Mangwani Jitendra
Leicester Orthopaedics, University Hospitals Leicester, United Kingdom.
Leicester Orthopaedics, University Hospitals Leicester, United Kingdom.
Foot Ankle Surg. 2017 Sep;23(3):189-194. doi: 10.1016/j.fas.2016.05.317. Epub 2016 May 18.
The aim of this systematic review was to perform a qualitative synthesis of the current literature to determine the union frequencies for first metatarsophalangeal joint arthrodesis as well as the influence of pathology, joint preparation and fixation methods on union.
MEDLINE and EMBASE were searched to identify relevant studies reporting on first metatarsophalangeal joint union frequencies.
26 studies with 2059 feet met our inclusion criteria. The mean age was 60 years (range 18-84) and the mean follow-up was 32.6 months (range 1.5-156). The union frequency was 93.5% (1923/2059). The union frequencies were significantly higher when low velocity joint preparation methods were used (P<0.0001, Chi Square 22.5) and the pathology was hallux rigidus (P=0.002, Chi square 9.3). There were similarly high union frequencies with crossed screws, locking plate and non-locking plates.
High union frequency can be expected following first metatarsophalangeal arthrodesis, especially when low velocity joint preparation methods are used in patients with hallux rigidus.
本系统评价的目的是对当前文献进行定性综合分析，以确定第一跖趾关节融合术的愈合频率，以及病变、关节准备和固定方法对愈合的影响。
检索MEDLINE和EMBASE数据库，以识别报告第一跖趾关节愈合频率的相关研究。
26项研究共纳入2059只足，符合纳入标准。平均年龄为60岁（范围18 - 84岁），平均随访时间为32.6个月（范围1.5 - 156个月）。愈合频率为93.5%（1923/2059）。当使用低速关节准备方法时，愈合频率显著更高（P<0.0001，卡方值22.5），病变为僵硬拇趾时愈合频率也显著更高（P = 0.002，卡方值9.3）。交叉螺钉、锁定钢板和非锁定钢板的愈合频率同样较高。
第一跖趾关节融合术后可预期有较高的愈合频率，尤其是在僵硬拇趾患者中使用低速关节准备方法时。
