Waizy H, Jowett C, Andric V
Clinic for Foot and Ankle Surgery, Hessing Foundation, Hessing Str. 17, 86199 Augsburg, Germany; Laboratory for Biomechanics and Biomaterials, Hannover Medical School, Anna-von-Borries-Str. 1-7, 30625 Hannover, Germany.
York Hospitals NHS Foundation Trust, Wigginton Road, York, N Yorkshire YO31 8HE, UK.
Foot (Edinb). 2018 Dec;37:113-118. doi: 10.1016/j.foot.2018.06.005. Epub 2018 Jun 20.
The calcaneal osteotomies is often performed to correct asymptomatic hindfoot deformities. More recently minimally invasive techniques have been described with promising clinical outcomes. In a prospective study we compared the intraoperative parameters of the open and minimalinvasive (MICO) techniques, which has not previously been reported.
60 consecutive with calcaneal osteotomy (33 open and 27 MICO) and a minimum follow up of 12 weeks were included. We recorded the following intraoperative parameters: operation time for the osteotomy [min], the fluoroscopy time, the fluoroscopy dose and the skin incision. The clinical (FAOS) and radiological outcome were examined 6 and 12 weeks postoperatively. The Wilcoxon test and the continuity correction were used with alpha=5% value for the statistical significance.
The minimally invasive group showed a significantly shorter operation time. There was no significant difference between the radiation time and dose in the two groups. The length of the incision in the minimally invasive group was significantly shorter. We found no difference in clinical outcome and radiological follow up.
This study reports a significantly shorter operating time and a shorter incision in the MICO group. The radiation exposition was not significantly different between the two groups. A clinical difference could not be shown in our study. However, we see the shorter operating time of the minimally invasive calcaneal osteotomy being beneficial.
跟骨截骨术常用于矫正无症状的后足畸形。最近，已有关于微创技术的报道，其临床效果良好。在一项前瞻性研究中，我们比较了开放手术和微创（MICO）技术的术中参数，此前尚未有相关报道。
纳入60例连续接受跟骨截骨术的患者（33例行开放手术，27例行MICO手术），且至少随访12周。我们记录了以下术中参数：截骨手术时间[分钟]、透视时间、透视剂量和皮肤切口。在术后6周和12周检查临床（FAOS）和影像学结果。采用Wilcoxon检验和连续性校正，α值为5%作为统计学显著性标准。
微创组的手术时间明显更短。两组的透视时间和剂量无显著差异。微创组的切口长度明显更短。我们发现临床结果和影像学随访无差异。
本研究报告MICO组的手术时间明显更短，切口也更短。两组之间的辐射暴露无显著差异。在我们的研究中未显示出临床差异。然而，我们认为微创跟骨截骨术较短的手术时间是有益的。
