Nickel Kevin J, Van Slyke Aaron C, Knox Aaron D, Wing Kevin, Wells Neil
Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
Division of Plastic Surgery, Department of Surgery, University of British Columbia, Vancouver, British Columbia, Canada.
Plast Surg (Oakv). 2018 Nov;26(4):244-249. doi: 10.1177/2292550317749510. Epub 2018 Jan 9.
Tissue expansion in the lower extremity is controversial, with studies reporting complication rates as high as 83%. Few studies have looked at tissue expansion prior to orthopaedic correction of severe foot and ankle deformities, and those available are restricted to clubfoot in the pediatric population. Here, we report the largest case series on the use of tissue expanders for the reconstruction of severe foot and ankle deformity and the only report in adults.
This is a retrospective chart review of the senior author's practice over a 16-year study period. All patients over 18 years of age who underwent tissue expansion prior to definitive orthopaedic correction of a severe foot and ankle deformity were included. Patient demographics, etiology of deformity, rate of expansion, and complications were recorded. Major complications were defined as those which required surgical intervention. Data were analyzed using descriptive statistics.
Nineteen cases were performed on 16 patients. Our overall complication rate was 31.6% (6/19), with major complications occurring in 21.1% (4/19) of cases, and minor complications occurring in 10.5% (2/19) of cases. Despite this, 94.7% (18/19) of cases went on to receive definitive orthopaedic correction after tissue expansion. No demographic parameters were associated with occurrence of complications.
This represents the largest report on lower extremity tissue expansion for severe foot and ankle deformity correction. While we observed complications in 31.6% of patients, 94.7% of cases went on to receive definitive orthopaedic correction with successful primary closure.
下肢组织扩张存在争议，一些研究报告的并发症发生率高达83%。很少有研究关注在对严重足踝畸形进行骨科矫正之前的组织扩张情况，现有研究仅限于儿科人群中的马蹄内翻足。在此，我们报告了关于使用组织扩张器重建严重足踝畸形的最大病例系列，也是唯一一篇关于成人的报告。
这是对资深作者16年研究期间临床实践的回顾性图表分析。纳入所有18岁以上在对严重足踝畸形进行最终骨科矫正之前接受组织扩张的患者。记录患者的人口统计学数据、畸形病因、扩张率和并发症情况。主要并发症定义为需要手术干预的并发症。采用描述性统计方法对数据进行分析。
对16例患者实施了19例手术。我们的总体并发症发生率为31.6%（6/19），其中主要并发症发生率为21.1%（4/19），次要并发症发生率为10.5%（2/19）。尽管如此，94.7%（18/19）的病例在组织扩张后继续接受了最终的骨科矫正。没有人口统计学参数与并发症的发生相关。
这是关于使用下肢组织扩张矫正严重足踝畸形的最大规模报告。虽然我们观察到31.6%的患者出现了并发症，但94.7%的病例最终成功进行了一期缝合的骨科矫正。
