小儿有症状副舟骨非手术治疗的有效性
Effectiveness of Nonoperative Treatment of the Symptomatic Accessory Navicular in Pediatric Patients.
作者信息
Wynn Malynda, Brady Candice, Cola Kristin, Rice-Denning Jaime
机构信息
University of Iowa Hospitals & Clinics, Department of Orthopaedics & Rehabilitation, Iowa City, IA USA.
Department of Orthopaedic Surgery at Desert Orthopaedic Center, Las Vegas, NV USA.
出版信息
Iowa Orthop J. 2019;39(1):45-49.
BACKGROUND
Initial management of symptomatic accessory navicular in pediatric patients is nonoperative. However, efficacy of nonoperative treatment has not been studied or established. If nonoperative treatment is frequently unsuccessful or does not give lasting pain relief, surgery could be offered as first line treatment. This study retrospectively reviewed outcomes of pediatric patients treated nonoperatively for symptomatic accessory naviculae in an effort to provide clinicians success rates for their discussion of treatment options with patients and their families.
METHODS
A retrospective analysis of pediatric patients diagnosed and treated nonoperatively for a symptomatic accessory navicular bone at Cincinnati Children's Hospital Medical Center between dates August 1, 2006 and August 24, 2016 was performed. Outcome measures consisted of complete pain relief, partial relief without operative intervention, or need for operative intervention. Radiographic imaging for each patient was also used to identify the type of accessory navicular and presence of concurrent pes planus.
RESULTS
A total of 169 patients were included, with 226 symptomatic accessory naviculae. Average age at diagnosis was 11.8 years, with majority females (78%). Type 2 accessory naviculae were most frequent (72.7%), with Type 1 and Type 3 in 9.7% and 17.4%, respectively. Average number of nonoperative trials was 2.1, with 28% experiencing complete pain relief, 30% requiring surgical intervention, and 41% that experienced partial pain relief and did not require surgical intervention, and were recommended as needed (PRN) follow-up based on clinical improvement. Of those that achieved complete pain relief, the average length of non-operative treatment was 8.0 months.
CONCLUSIONS
The results of this study can be used by clinicians to frame discussions surrounding treatment options for symptomatic accessory navicular bones with both patients and their families. III.
背景
小儿有症状的副舟骨的初始治疗为非手术治疗。然而，非手术治疗的疗效尚未得到研究或确立。如果非手术治疗经常失败或不能持久缓解疼痛，可将手术作为一线治疗方法。本研究回顾性分析了小儿有症状的副舟骨非手术治疗的结果，旨在为临床医生与患者及其家属讨论治疗方案时提供成功率参考。
方法
对2006年8月1日至2016年8月24日在辛辛那提儿童医院医疗中心诊断并接受非手术治疗的有症状副舟骨的小儿患者进行回顾性分析。结果指标包括疼痛完全缓解、无需手术干预的部分缓解或需要手术干预。还对每位患者进行影像学检查，以确定副舟骨的类型和是否合并扁平足。
结果
共纳入169例患者，有226个有症状的副舟骨。诊断时的平均年龄为11.8岁，大多数为女性（78%）。2型副舟骨最常见（72.7%），1型和3型分别占9.7%和17.4%。非手术治疗的平均次数为2.1次，28%的患者疼痛完全缓解，30%的患者需要手术干预，41%的患者疼痛部分缓解且无需手术干预，并根据临床改善情况建议按需（PRN）随访。在疼痛完全缓解的患者中，非手术治疗的平均时长为8.0个月。
结论
本研究结果可供临床医生用于与患者及其家属围绕有症状副舟骨的治疗方案进行讨论。三级。
Zotero 插件