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不同的固定结构与第一跖趾关节融合术后不愈合的风险

Different fixation constructs and the risk of non-union following first metatarsophalangeal joint arthrodesis.

作者信息

Cichero Matthew J, Yates Ben J, Joyce Anthony S D, Williamson David M, Walsh Tom P

机构信息

Department of Trauma & Orthopaedics, Great Western Hospital Foundation Trust, Swindon, Wiltshire, SN3 6BB England, United Kingdom.

Department of Trauma & Orthopaedics, Great Western Hospital Foundation Trust, Swindon, Wiltshire, SN3 6BB England, United Kingdom.

出版信息

Foot Ankle Surg. 2021 Oct;27(7):789-792. doi: 10.1016/j.fas.2020.10.006. Epub 2020 Oct 25.

Abstract

BACKGROUND

The aim of this study was to determine if a single or separate construct with interfragmentary screw was associated with higher rates non-union following first metatarsophalangeal joint (MTPJ) arthrodesis.

METHODS

A retrospective analysis of patients undergoing first MTPJ arthrodesis between April 2010 and June 2017 was performed. Patients who received either a single (Stryker Anchorage 1 MTP Cross Plate) or separate (Stryker Anchorage 1 MTP locking plate with one Asnis partially threaded compression screw) construct locking plate and interfragmentary compression screw were reviewed. Descriptive statistics were generated for sample demographics and between-group differences were calculated. Multivariable regressions explored internal fixation type and association with non-union.

RESULTS

A total of 280 first MTPJ arthrodesis met the inclusion criteria and were reviewed. The incidence of non-union was 7.9% of procedures (22 joints). Following multivariable binary logistic regression, the single construct locking plate with interfragmentary compression screw was associated with an increased risk of non-union (OR 3.43, 95% CI 1.26-9.33), adjusting for age, gender and comorbidity.

CONCLUSIONS

A single construct interfragmentary screw and locking plate (Stryker Anchorage 1 MTP Cross Plate) was associated with an increased incidence of non-union following first MTPJ arthrodesis.

摘要

背景

本研究的目的是确定在第一跖趾关节(MTPJ)融合术中,使用单一结构或带有骨折块间螺钉的独立结构是否会导致更高的不愈合率。

方法

对2010年4月至2017年6月期间接受首次MTPJ融合术的患者进行回顾性分析。对接受单一结构(史赛克锚固1型MTP交叉钢板)或独立结构(史赛克锚固1型MTP锁定钢板加一枚阿斯尼斯部分螺纹加压螺钉)锁定钢板和骨折块间加压螺钉的患者进行评估。对样本人口统计学数据进行描述性统计,并计算组间差异。多变量回归分析探讨内固定类型与不愈合的相关性。

结果

共有280例首次MTPJ融合术符合纳入标准并接受评估。不愈合发生率为手术例数的7.9%(22个关节)。多变量二元逻辑回归分析显示,在调整年龄、性别和合并症后,带有骨折块间加压螺钉的单一结构锁定钢板与不愈合风险增加相关(比值比3.43,95%置信区间1.26 - 9.33)。

结论

在首次MTPJ融合术后,单一结构的骨折块间螺钉和锁定钢板(史赛克锚固1型MTP交叉钢板)与不愈合发生率增加相关。

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