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初次全踝关节置换术中的感染:前路与经腓骨外侧入路对比

Infections in primary total ankle replacement: Anterior approach versus lateral transfibular approach.

作者信息

Usuelli Federico Giuseppe, Indino Cristian, Maccario Camilla, Manzi Luigi, Liuni Federico Maria, Vulcano Ettore

机构信息

IRCCS Istituto Ortopedico Galeazzi, Milan, Italy.

IRCCS Istituto Ortopedico Galeazzi, Milan, Italy.

出版信息

Foot Ankle Surg. 2019 Feb;25(1):19-23. doi: 10.1016/j.fas.2017.07.643. Epub 2017 Aug 4.

Abstract

BACKGROUND

Total ankle replacement (TAR) represents an alternative to fusion for the treatment of end-stage ankle osteoarthritis. The aim of the present study was to retrospectively assess the frequency of infections between TARs with anterior and lateral transfibular approach at 12-months follow-up.

METHODS

81 TARs through an anterior approach and 69 TARs through a lateral approach were performed between May 2011 and July 2015. We compared surgical time and tourniquet time, as well as superficial and deep infections frequency during the first 12 postoperative months.

RESULTS

In the anterior approach group, there were 3 (3.7%) deep infections and 4 (4.9%) superficial wound infections. In the lateral approach group, there were 1 (1.4%) deep infection and 2 superficial wound infections (2.9%). There were not statistically significant differences between the groups. There was a significant difference between anterior approach (115minutes) and lateral approach group (179minutes) in terms of surgical time (P<0.001).

CONCLUSIONS

The frequency of superficial and deep periprosthetic infections during the first postoperative year was not significantly different in the lateral approach group compared to the anterior approach group, despite the significantly longer surgical time in the lateral transfibular approach group.

摘要

背景

全踝关节置换术(TAR)是治疗终末期踝关节骨关节炎的一种替代融合术的方法。本研究的目的是回顾性评估在12个月随访时,采用前侧和外侧经腓骨入路的全踝关节置换术之间感染的发生率。

方法

在2011年5月至2015年7月期间,分别采用前侧入路进行了81例全踝关节置换术,采用外侧入路进行了69例全踝关节置换术。我们比较了手术时间、止血带时间,以及术后前12个月内表浅和深部感染的发生率。

结果

在前侧入路组中,有3例(3.7%)深部感染和4例(4.9%)表浅伤口感染。在外侧入路组中,有1例(1.4%)深部感染和2例表浅伤口感染(2.9%)。两组之间无统计学显著差异。在前侧入路组(115分钟)和外侧入路组(179分钟)之间,手术时间存在显著差异(P<0.001)。

结论

尽管外侧经腓骨入路组的手术时间明显更长,但术后第一年外侧入路组与前侧入路组相比,假体周围表浅和深部感染的发生率无显著差异。

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