Baron Marissa E, Minteer Danielle M, Gusenoff Beth R, Gusenoff Jeffrey A
School of Medicine and the Department of Plastic Surgery, University of Pittsburgh, Pittsburgh, PA.
Aesthet Surg J Open Forum. 2020 Jun 24;2(3):ojaa031. doi: 10.1093/asjof/ojaa031. eCollection 2020 Sep.
Pedal fat grafting has been shown to improve pain and functional impairment from forefoot fat pad atrophy.
The authors aimed to determine if patient demographics and foot characteristics play a role in the level of impact that is achieved following surgery.
The authors performed a retrospective review of patients who received forefoot autologous fat injections for the treatment of pedal fat pad atrophy. Patient improvement of pain and functional impairment were evaluated for correlation with patient characteristics, including gender, age, BMI, unilateral vs bilateral injections, flexible vs rigid arch, previous foot deformity or surgery, and presence of callus.
Forty-four patients received fat injections into the ball of their foot; 73% of them were women; their mean age was 61 years, and mean BMI was 26.6 kg/m; 75% had injections performed bilaterally; 41% had a flexible arch, 73% had a past history of pedal deformity or surgery, and 43% had callus. Only female gender was found to correlate with an improvement in pain from the time of surgery to 12 months later ( = 0.02).
Bilateral rigid, high arched foot type is a risk factor for foot pain and disproportionately represented among these patients. The only patient characteristic found to be correlated with improvement in pain at 12 months post-surgery was female gender. BMI and laterality of injections impacted the course of improvement after surgery. Given current data, all patients with suspected pedal fat pad atrophy should be considered for soft tissue augmentation.
足部脂肪移植已被证明可改善前足脂肪垫萎缩引起的疼痛和功能障碍。
作者旨在确定患者人口统计学特征和足部特征是否对手术后所达到的影响程度起作用。
作者对接受前足自体脂肪注射治疗足部脂肪垫萎缩的患者进行了回顾性研究。评估患者疼痛和功能障碍的改善情况与患者特征的相关性，这些特征包括性别、年龄、体重指数、单侧注射与双侧注射、足弓灵活与僵硬、既往足部畸形或手术史以及胼胝的存在情况。
44例患者接受了足部球部的脂肪注射；其中73%为女性；平均年龄为61岁，平均体重指数为26.6kg/m；75%接受了双侧注射；41%足弓灵活，73%有既往足部畸形或手术史，43%有胼胝。仅发现女性性别与从手术时到12个月后疼痛的改善相关（P = 0.02）。
双侧僵硬、高弓足类型是足部疼痛的危险因素，且在这些患者中比例过高。发现与术后12个月疼痛改善相关的唯一患者特征是女性性别。体重指数和注射的侧别影响手术后的改善进程。根据目前的数据，所有疑似足部脂肪垫萎缩的患者都应考虑进行软组织填充。
