奥姆斯特德县有症状的小儿跗骨联合症的发病率：一项基于人群的研究。

Incidence of Symptomatic Pediatric Tarsal Coalition in Olmsted County: A Population-Based Study.

机构信息

Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota.

出版信息

J Bone Joint Surg Am. 2021 Jan 20;103(2):155-161. doi: 10.2106/JBJS.20.00707.

DOI:10.2106/JBJS.20.00707

PMID:33186000

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8456776/

Abstract

BACKGROUND

Tarsal coalitions are an important reason for foot pain in children. Early estimates placed the prevalence at up to 2%, while more recent data suggest that it is as high as 11% to 13%. To our knowledge, there have been no population-based studies to determine the true incidence of symptomatic tarsal coalitions in a pediatric population.

METHODS

A population-based database was used to identify all new diagnoses of symptomatic tarsal coalitions in children 18 years old or younger between 1966 and 2018. Patient records were reviewed for clinical data, and comparisons were made between the types and characteristics of the coalitions identified to determine differences in the affected populations. The annual age-specific, sex-specific, and type-specific incidence rates were estimated.

RESULTS

During the study period, 58 patients with a total of 79 symptomatic tarsal coalitions were identified (annual incidence = 3.5 per 100,000 children). There were 43 calcaneonavicular (CN) coalitions (annual incidence = 1.9 per 100,000 children), 27 talocalcaneal (TC) coalitions (annual incidence = 1.2 per 100,000 children), as well as 9 other coalitions (7 talonavicular, 1 naviculocuboid, and 1 naviculocuneiform) (annual incidence = 0.4 per 100,000 children). The overall incidence peaked between the ages of 10 and 14 years for both boys and girls (8.1 per 100,000 and 7.4 per 100,000 children, respectively). Statistical differences were identified between the types of tarsal coalitions. TC coalitions present at an older age relative to CN and other coalitions (mean,13.9, 12.7, and 11.4 years, respectively; p = 0.02). While CN and TC coalitions were similar in composition (23% and 30%, respectively, were osseous as opposed to fibrocartilaginous), other coalitions were more likely to be osseous (78%) (p = 0.0035). Other coalitions were also less likely to require surgery than CN and TC coalitions (11%, 74%, and 56%, respectively; p = 0.0015).

CONCLUSIONS

This population-based study demonstrates differences in the clinical presentation of tarsal coalitions and provides an estimate of the true incidence of symptomatic tarsal coalitions in a pediatric population.

摘要

背景

跗骨联合是儿童足部疼痛的一个重要原因。早期估计患病率高达 2%，而最近的数据表明，患病率高达 11%至 13%。据我们所知，还没有基于人群的研究来确定儿童中症状性跗骨联合的真实发病率。

方法

使用基于人群的数据库来确定 1966 年至 2018 年间 18 岁以下儿童中所有新诊断的症状性跗骨联合的新病例。对患者记录进行了临床数据的审查，并对确定的联合类型和特征进行了比较，以确定受影响人群的差异。估计了每年特定年龄、特定性别和特定类型的发病率。

结果

在研究期间，共发现 58 例患儿（58 名患儿中有 79 个症状性跗骨联合）（发病率=每 100000 名儿童中 3.5 例）。其中有 43 例跟舟骨（CN）联合（发病率=每 100000 名儿童中 1.9 例），27 例距跟骨（TC）联合（发病率=每 100000 名儿童中 1.2 例），以及 9 例其他联合（7 例距舟骨，1 例舟楔骨，1 例舟骰骨）（发病率=每 100000 名儿童中 0.4 例）。无论是男孩还是女孩，跗骨联合的整体发病率在 10 至 14 岁之间达到峰值（分别为每 100000 名儿童中 8.1 例和 7.4 例）。不同类型的跗骨联合之间存在统计学差异。与 CN 和其他联合相比，TC 联合的发病年龄较大（分别为 13.9、12.7 和 11.4 岁；p=0.02）。尽管 CN 和 TC 联合在组成上相似（分别有 23%和 30%为骨-纤维软骨性，而其他联合则更可能为骨性），但其他联合的可能性较小（78%）（p=0.0035）。与 CN 和 TC 联合相比，其他联合更不可能需要手术（分别为 11%、74%和 56%；p=0.0015）。