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经皮关节镜下跟骨骨折切开复位内固定术治疗移位性关节内跟骨骨折:系统评价与手术技术。

Percutaneous arthroscopic calcaneal osteosynthesis for displaced intra-articular calcaneal fractures: Systematic review and surgical technique.

机构信息

Department of Orthopedic Surgery, Caremeau University Hospital, place du Professeur Robert Debré, 30029 Nimes, France.

Department of Orthopedic Surgery, Caremeau University Hospital, place du Professeur Robert Debré, 30029 Nimes, France.

出版信息

Foot Ankle Surg. 2020 Jul;26(5):503-508. doi: 10.1016/j.fas.2019.07.002. Epub 2019 Jul 10.

Abstract

BACKGROUND

The aim of this study was to systematically evaluate the available literature on technique and outcomes of percutaneous arthroscopic calcaneal osteosynthesis for displaced intra-articular calcaneal fractures.

METHODS

A systematic review of the literature available in MEDLINE, EMBASE, and the Cochrane Library database was performed, including studies from January 1985 to august 2018. The literature search, data extraction, and quality assessment were conducted by 2 independent reviewers. The surgical technique and perioperative management, clinical outcomes scores, radiographic outcomes and complication rate were evaluated.

RESULTS

Of 66 reviewed articles, 8 studies met the inclusion criteria. The included studies reported on the results of 152 patients. At last follow up the mean American Orthopaedic Foot & Ankle Society ankle-hindfoot was ranging from 72.1 to 94.1. The complication rate was low, including only one superficial infection.

CONCLUSIONS

The studies included were of too little level of evidence to allow for data pooling or meta-analysis. However, the percutaneous arthroscopic calcaneal osteosynthesis seems to be a good option for displaced intra-articular calcaneal fractures with a low complication rate. Appropriately powered randomized controlled trials with long-term follow up are needed to confirm the efficacy of this technique.

LEVEL OF EVIDENCE

Level III, systematic review of Level III studies.

摘要

背景

本研究旨在系统评价经皮关节镜跟骨截骨术治疗关节内移位跟骨骨折的技术和疗效的相关文献。

方法

对 MEDLINE、EMBASE 和 Cochrane 图书馆数据库中 1985 年 1 月至 2018 年 8 月的文献进行系统回顾,由 2 名独立评审员进行文献检索、数据提取和质量评估。评估手术技术和围手术期管理、临床疗效评分、影像学结果和并发症发生率。

结果

在 66 篇综述文章中,有 8 篇符合纳入标准。纳入的研究报告了 152 例患者的结果。末次随访时,美国矫形足踝协会(AOFAS)踝后足评分平均为 72.1 至 94.1。并发症发生率较低,仅 1 例浅表感染。

结论

纳入的研究证据水平较低,无法进行数据合并或荟萃分析。然而,经皮关节镜跟骨截骨术似乎是治疗关节内移位跟骨骨折的一种较好选择,并发症发生率低。需要进行适当的、有长期随访的随机对照试验来证实该技术的疗效。

证据等级

III 级,III 级研究的系统评价。

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