1 Anderson Orthopaedic Clinic, Arlington, VA, USA.
2 Department of Orthopaedic Surgery, Carolinas Medical Center, Charlotte, NC, USA.
Foot Ankle Int. 2018 Feb;39(2):172-179. doi: 10.1177/1071100717737740. Epub 2017 Oct 27.
The purpose of this study was to determine the radiographic union rate after midfoot and hindfoot arthrodeses using a new generation of nitinol staples, and to compare outcomes between a nitinol staple construct and a nitinol staple and threaded compression screw construct.
A retrospective chart review was performed to identify patients who underwent hindfoot or midfoot arthrodesis using a new generation of nitinol compression staples with or without a partially threaded cannulated screw with minimum 3-month radiographic follow-up. The primary outcome variable was radiographic evidence of arthrodesis on radiographs and, when available, computed tomographic scan in patients who underwent midfoot or hindfoot arthrodesis using nitinol staples. Ninety-six patients and 149 joints were eligible for analysis. Median radiographic follow-up was 5.7 months.
Radiographic union was seen in 93.8% (60/64) of patients and 95.1% (98/103) of joints using the nitinol staple construct. Radiographic union was seen in 90.6% (29/32) of patients and 95.7% (44/46) of joints using the nitinol combined staple and screw construct. There was no significant difference in radiographic union rate or revision surgery between the 2 groups. Seven patients developed nonunion, 4 in the nitinol staple construct group and 3 in the staple and screw group.
New-generation nitinol staples were safe and effective for hindfoot and midfoot arthrodeses, with a high radiographic union rate. The use of a partially threaded screw for additional fixation was not found to either significantly increase or decrease radiographic fusion with nitinol staple fixation.
Level III, comparative cohort study.
本研究旨在确定使用新一代镍钛诺钉进行中足和后足关节融合的放射学愈合率，并比较镍钛诺钉结构与镍钛诺钉和螺纹加压螺钉结构的结果。
回顾性图表审查，以确定使用新一代镍钛诺压缩钉进行后足或中足关节融合的患者，这些钉带有或不带有部分螺纹的空心螺钉，至少有 3 个月的放射影像学随访。主要观察变量是在使用镍钛诺钉进行中足或后足关节融合的患者的影像学和（如有）计算机断层扫描上的融合影像学证据。96 例患者和 149 个关节符合分析条件。中位影像学随访时间为 5.7 个月。
使用镍钛诺钉结构的患者中有 93.8%（60/64）和关节中有 95.1%（98/103）出现放射影像学愈合。使用镍钛诺联合钉和螺钉结构的患者中有 90.6%（29/32）和关节中有 95.7%（44/46）出现放射影像学愈合。两组在放射影像学愈合率或翻修手术方面无显著差异。7 例患者出现骨不连，其中 4 例在镍钛诺钉结构组，3 例在钉和螺钉组。
新一代镍钛诺钉用于后足和中足关节融合是安全有效的，具有较高的放射影像学愈合率。使用部分螺纹螺钉进行额外固定未发现明显增加或降低镍钛诺钉固定的放射影像学融合。
III 级，比较队列研究。
