Foot and Ankle Unit, Royal National Orthopaedic Hospital, Brockley Hill, Stanmore, Middlesex, HA7 4LP, UK.
Foot and Ankle Unit, Royal National Orthopaedic Hospital, Brockley Hill, Stanmore, Middlesex, HA7 4LP, UK.
Foot (Edinb). 2021 Jun;47:101815. doi: 10.1016/j.foot.2021.101815. Epub 2021 Apr 18.
One commonly encountered deformity within the cavovarus foot is plantarflexion of the first metatarsal which may be a primary or secondary deformity. Correcting the plantarflexion may be achieved through a dorsiflexion osteotomy although the optimal fixation device for this osteotomy has not been determined. This clinical study compared the outcomes using staples and locking plates.
A retrospective evaluation was performed of 52 feet that had undergone dorsiflexion osteotomy of the first metatarsal as part of a cavovarus foot correction with a minimum follow-up of two years. Data was collected on deformity correction, complications and cost-analysis.
As a cohort, Meary's angle improved from 13.4° to 7.72° (p < 0.001), Hibbs' angle improved from 117.1° to 124.2° (p < 0.001) and navicular height dropped from 52.7 mm to 47.7 mm (p < 0.001) while calcaneal inclination changed from 20.9° to 21.2° but this did not reach significance (p = 0.66). These indices and the number of complications were not significantly different between the staple and locking plate group. The overall cost of using staples was less than using locking plates.
Both staples and locking plates are effective devices for fixation of the first metatarsal after a dorsiflexion osteotomy in cavovarus foot surgery. They were both able to provide comparable fixation, although staples were less expensive to use in our study.
在高弓内翻足中，常见的畸形之一是第一跖骨的跖屈，这可能是原发性或继发性畸形。纠正跖屈可以通过背屈截骨术来实现，尽管这种截骨术的最佳固定装置尚未确定。本临床研究比较了使用钢钉和锁定板的结果。
对 52 例接受第一跖骨背屈截骨术的患者进行回顾性评估，这些患者均为高弓内翻足矫正的一部分，随访时间至少为两年。收集了畸形矫正、并发症和成本分析的数据。
作为一个队列，Meary 角从 13.4°改善至 7.72°（p<0.001），Hibbs 角从 117.1°改善至 124.2°（p<0.001），舟骨高度从 52.7mm下降至 47.7mm（p<0.001），而跟骨倾斜度从 20.9°变为 21.2°，但这没有达到显著性（p=0.66）。这些指数和并发症的数量在钢钉和锁定板组之间没有显著差异。使用钢钉的总体成本低于使用锁定板。
在高弓内翻足手术中，钢钉和锁定板都是第一跖骨背屈截骨术后固定的有效装置。它们都能提供类似的固定效果，尽管在我们的研究中使用钢钉更便宜。
