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三维打印外固定架结合逆行髓内钉治疗跟距关节融合术:早期结果。

Three-Dimensional Printed Cage in Patients With Tibiotalocalcaneal Arthrodesis Using a Retrograde Intramedullary Nail: Early Outcomes.

机构信息

Division of Sports Medicine, Department of Orthopaedic Surgery, University of Illinois at Chicago, Illinois (LBP).

Department of Orthopaedic Surgery, Duke University, Durham, North Carolina (AS, SBA, SGP).

出版信息

Foot Ankle Spec. 2021 Oct;14(5):401-409. doi: 10.1177/1938640020920947. Epub 2020 May 11.

Abstract

. Segmental bone loss in the hindfoot hinders the chance of successful outcomes. Tibiotalocalcaneal arthrodesis is a reliable option; nevertheless, the risk of nonunion is high. Three-dimensional (3D) printed titanium implants offer a strong scaffold that can be customized and has demonstrated encouraging healing rates. In this study, we described the clinical outcomes and the radiologic union rate of a case series of patients with hindfoot arthrodesis, using a retrograde intramedullary nail associated to a 3D printed titanium cage. . Seven patients undergoing hindfoot arthrodesis, using a retrograde intramedullary nail associated to a custom 3D printed titanium cage, were included. Demographic data were collected. Functional outcomes were assessed using the American Orthopedic Foot and Ankle Score and the Visual Analogue Scale for pain. Hindfoot alignment and radiographic union were evaluated using weight-bearing radiographs and computed tomography scan, respectively. . A total of 6 (85%) patients had more than 50% bony bridging. Only 1 patient underwent below knee amputation due to recurrence of chronic osteomyelitis. Two additional patients had minor complications. . Tibiotalocalcaneal arthrodesis using customized titanium cages for patients with large bone defects has shown a high rate of union in those at risk of nonunion. However, further research with larger series is needed. Level IV: Case series.

摘要

. 后足节段性骨丢失妨碍了获得成功的机会。距下关节融合术是一种可靠的选择,但不愈合的风险很高。三维(3D)打印钛植入物提供了一个强大的支架,可以定制,并已显示出令人鼓舞的愈合率。在这项研究中,我们描述了使用逆行髓内钉联合 3D 打印钛笼治疗后足融合的一系列患者的临床结果和放射学融合率。. 纳入了 7 例使用逆行髓内钉联合定制 3D 打印钛笼进行后足融合的患者。收集了人口统计学数据。使用美国矫形足踝协会评分和疼痛视觉模拟评分评估功能结果。后足对线和影像学融合分别采用负重位 X 线片和 CT 扫描进行评估。. 共有 6 例(85%)患者有超过 50%的骨桥接。只有 1 例患者因慢性骨髓炎复发而行膝下截肢。另外 2 例患者有轻微并发症。. 对于有大骨缺损的患者,使用定制钛笼进行距下关节融合术,在有不愈合风险的患者中显示出很高的融合率。然而,需要进一步进行更大系列的研究。等级 IV:病例系列。

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