Claassen Leif, Plaass Christian, Pastor Marc-Frederic, Ettinger Sarah, Wellmann Mathias, Stukenborg-Colsman Christina, Hosseinian Sayyed Hadi Sayyed, Waizy Hazibullah
Hannover Medical School, Orthopedic Department, Hannover, Germany.
Arch Bone Jt Surg. 2017 Jul;5(4):221-225.
Locking plate fixation is increasingly used for first metatarsophalangeal joint (MTP-I) arthrodesis. There are still few comparable clinical data regarding this procedure. In this study we aimed to compare the clinical and radiographical outcomes of crossed-screws, locking and non-locking plate fixation with lag screw for first metatarsophalangeal joint arthrodesis.
A total of 60 patients who had undergone arthrodesis of the MTP-I between January 2008 and June 2010 were retrospectively evaluated. Locking plate fixation with lag screw as well as arthrodesis with crossed-screws or with a non-locking plate with lag screw was performed on three groups of 20 patients.
There were four non-unions in patients with crossed-screws and one in non-locked plate group. All patients in locking plate group achieved union. 90% of the patients were completely or mildly satisfied in locking plate group, whereas this rate was 80% for patients in both crossed-screws and non-locking plate groups.
Use of dorsal plating for arthrodesis of MTP-I joint, either locking or non-locking, were associated with high union rate and acceptable and comparable functional outcome. Although the rate of nonunion was higher with two crossed-screws, however, the functional outcome was not significantly different compared to dorsal plating.
锁定钢板固定越来越多地用于第一跖趾关节（MTP-I）融合术。关于该手术的可比临床数据仍然很少。在本研究中，我们旨在比较交叉螺钉、锁定钢板和带拉力螺钉的非锁定钢板固定用于第一跖趾关节融合术的临床和影像学结果。
回顾性评估2008年1月至2010年6月期间接受MTP-I关节融合术的60例患者。对三组各20例患者分别进行带拉力螺钉的锁定钢板固定以及交叉螺钉或带拉力螺钉的非锁定钢板关节融合术。
交叉螺钉组有4例骨不连，非锁定钢板组有1例骨不连。锁定钢板组所有患者均实现骨愈合。锁定钢板组90%的患者完全或轻度满意，而交叉螺钉组和非锁定钢板组患者的这一比例为80%。
使用背侧钢板进行MTP-I关节融合术，无论是锁定还是非锁定，骨愈合率都很高，功能结果可接受且具有可比性。虽然两根交叉螺钉的骨不连发生率较高，但其功能结果与背侧钢板相比无显著差异。
