跗骨联合融合术后非融合的风险因素：系统评价和荟萃分析。
Risk factors for nonunion following tibiotalocalcaneal arthrodesis: A systematic review and meta-analysis.
机构信息
Department of Orthopaedics at Miller School of Medicine, University of Miami, Miami, FL, United States.
Leni & Peter W. May Department of Orthopaedic Surgery, Mount Sinai, New York City, NY, United States.
出版信息
Foot Ankle Surg. 2022 Jan;28(1):7-13. doi: 10.1016/j.fas.2021.02.010. Epub 2021 Mar 1.
BACKGROUND
The goal of this study is to review the literature to identify risk factors for nonunion after tibiotalocalcaneal arthrodesis (TTCA) and stratify them based on strength of evidence.
METHODS
Five databases were searched from inception to May 17th, 2020. Abstracts and full-text articles were screened for those that included risk factors predictive of nonunion following TTCA.
RESULTS
Eight studies involving 624 patients were included and 33 potential risk factors for nonunion were identified. Strong evidence supported prior peripheral neuropathic conditions as risk factors for nonunion following surgery (OR: 2.86, 95% CI: 1.56-5.23).
CONCLUSION
TTCA is an effective salvage procedure but is associated with high nonunion rates. The results of our meta-analysis suggest that prior peripheral neuropathic conditions have strong evidence for failure to achieve union. Surgeons should be cognizant of these risks when performing TTCA and carefully monitor patients with the aforementioned comorbidity to achieve successful results.
背景
本研究旨在回顾文献，确定距下关节融合术（TTCA）后骨不连的危险因素，并根据证据强度对其进行分层。
方法
从建库到 2020 年 5 月 17 日，我们检索了五个数据库。筛选出包含 TTCA 后骨不连预测因素的摘要和全文文章。
结果
共纳入 8 项研究 624 例患者，确定了 33 个潜在的骨不连危险因素。有强有力的证据支持先前的周围神经病变是手术失败的危险因素（OR：2.86，95%CI：1.56-5.23）。
结论
TTCA 是一种有效的挽救性手术，但与高骨不连率相关。我们的荟萃分析结果表明，先前的周围神经病变是导致不愈合的有力证据。当进行 TTCA 时，外科医生应意识到这些风险，并仔细监测有上述合并症的患者，以获得成功的结果。
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