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跟骨滑动截骨术单枚螺钉与双枚螺钉固定的愈合率及并发症比较

A comparison of union rates and complications between single screw and double screw fixation of sliding calcaneal osteotomy.

作者信息

SahraNavard Bahman, Hudson Parke W, de Cesar Netto Cesar, Wills Bradley W, Araoye Ibukunoluwa B, Bergstresser Shelby, Cone Brent M, Shah Ashish

机构信息

University of Alabama at Birmingham, 1313 13th Street South, Birmingham, AL 35205, USA.

出版信息

Foot Ankle Surg. 2019 Feb;25(1):84-89. doi: 10.1016/j.fas.2017.08.007. Epub 2017 Sep 6.

Abstract

BACKGROUND

The number of screws used for sliding calcaneal osteotomy fixation has not been examined in the literature. The purpose of this paper is to examine this topic.

METHODS

Retrospective chart review was performed on 190 patients who met selection criteria. We compared complication risk for single versus double screw, headed versus headless screw, and short versus longitudinal incision cases.

RESULTS

The mean age was 48.4 (18-83) years and average follow up was 28 (12-150) weeks. All cases achieved radiographic union. Overall complication rate was 19.5% (37/190). Risk of complication did not differ significantly between single and double screw (RR: 1.170; 95% CI: 0.66-2.09; p=0.594) or short and extended incision groups (RR: 0.868; 95% CI: 0.42-1.80; p=0.704). Risk of complication differed significantly between headed and headless screw fixation (RR: 5.558; 95% CI: 2.69-11.50; p<0.0001).

CONCLUSIONS

Single screw fixation of sliding calcaneal osteotomy achieves similar outcomes as double screw fixation. Headless screws are advantageous for minimizing hardware pain and subsequent hardware removal.

摘要

背景

文献中尚未对用于跟骨滑动截骨固定的螺钉数量进行研究。本文旨在探讨这一主题。

方法

对190例符合入选标准的患者进行回顾性病历审查。我们比较了单枚螺钉与双枚螺钉、有头螺钉与无头螺钉以及短切口与纵切口病例的并发症风险。

结果

平均年龄为48.4岁(18 - 83岁),平均随访时间为28周(12 - 150周)。所有病例均实现影像学愈合。总体并发症发生率为19.5%(37/190)。单枚螺钉与双枚螺钉(相对危险度:1.170;95%置信区间:0.66 - 2.09;p = 0.594)或短切口与长切口组(相对危险度:0.868;95%置信区间:0.42 - 1.80;p = 0.704)之间的并发症风险无显著差异。有头螺钉与无头螺钉固定之间的并发症风险有显著差异(相对危险度:5.558;95%置信区间:2.69 - 11.50;p < 0.0001)。

结论

跟骨滑动截骨的单枚螺钉固定与双枚螺钉固定效果相似。无头螺钉有利于将内置物相关疼痛及后续取出内置物的情况降至最低。

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