Suppr超能文献

使用泰勒空间框架矫正夏科氏关节病所致足部畸形:7至14年随访

Correction of Foot Deformities from Charcot Arthropathy with the Taylor Spatial Frame: A 7-14-year Follow-up.

作者信息

Lahoti Om, Abhishetty Naveen, Shetty Sandesh

机构信息

Department of Orthopaedics and Trauma, King's College Hospital, London, United Kingdom.

出版信息

Strategies Trauma Limb Reconstr. 2021 May-Aug;16(2):96-101. doi: 10.5005/jp-journals-10080-1525.

Abstract

Charcot arthropathy related foot and ankle deformities are a serious challenge. Surgical treatment of these deformities is now well established. Conventional surgical treatment includes extensive surgical exposure, excision of bone, acute correction and internal fixation, which is not always appropriate in presence of active ulceration, infection and poor bone quality. A minimally invasive approach to osteotomies and gradual correction of deformities using a circular frame are proving helpful in minimizing the complications. Taylor Spatial Frame (TSF) hexapod with its various modules is well suited for a range of foot and ankle deformities. We have advocated minimally invasive targeted hind and mid foot osteotomies and gradual correction with Taylor Spatial Frame (TSF) in 10 patients with recurrent ulceration and deformity. There are 2 female and 8 male patients in this cohort. Appropriate TSF module was chosen for each patient- a long bone module for ankle and hindfoot deformities (4 patients) and a forefoot 6x6 butt frame (6 patients) for foot deformities. An osteotomy through the midfoot was performed in all chronic stable foot deformity cases. In the ankle and hindfoot deformities, a combination of soft tissue distraction correction of equinus and acute correction of hindfoot deformity through a calcaneal osteotomy, were used. Our outcome measures are complete healing of the ulcers and resolution of infection, clinically plantigrade foot and ability to wear regular or diabetic footwear. Complications included eight episodes of pin infection that responded to oral antibiotics only and two pin breakages. We achieved ulcer and infection free plantigrade feet that fit in to regular or diabetic footwear in 9 out of 10 patients. 9 patients remain ulcer and infection free at a minimum of 7 years and maximum of 14 years follow up. Taylor Spatial Frame treatment provides an alternative to conventional surgery in high-risk complex Charcot neuroarthropathy foot and ankle deformities. Lahoti O, Abhishetty N, Shetty S. Correction of Foot Deformities from Charcot Arthropathy with the Taylor Spatial Frame: A 7-14-year Follow-up. Strategies Trauma Limb Reconstr 2021;16(2):96-101.

摘要

与夏科氏关节病相关的足踝畸形是一项严峻挑战。目前,针对这些畸形的外科治疗已得到充分确立。传统外科治疗包括广泛的手术暴露、骨切除、急性矫正和内固定,而在存在活动性溃疡、感染及骨质不佳的情况下,这种治疗方式并不总是合适的。事实证明,采用环形框架进行截骨术及逐步矫正畸形的微创方法有助于将并发症降至最低。带有各种模块的泰勒空间框架(TSF)六足架非常适合一系列足踝畸形。我们主张对10例复发性溃疡和畸形患者采用微创靶向性后足和中足截骨术,并使用泰勒空间框架(TSF)进行逐步矫正。该队列中有2名女性患者和8名男性患者。为每位患者选择了合适的TSF模块——用于踝部和后足畸形的长骨模块(4例患者)以及用于足部畸形的前足6×6对接框架(6例患者)。在所有慢性稳定型足部畸形病例中均进行了经中足的截骨术。对于踝部和后足畸形,采用了跟腱挛缩的软组织牵张矫正与通过跟骨截骨术对后足畸形进行急性矫正相结合的方法。我们的疗效指标包括溃疡完全愈合、感染消退、临床上足放平以及能够穿着常规或糖尿病专用鞋。并发症包括8次仅对口服抗生素有反应的钢针感染发作和2次钢针断裂。我们使10例患者中的9例实现了溃疡和感染治愈且足放平,能够穿着常规或糖尿病专用鞋。在至少7年、最长14年的随访中,9例患者仍无溃疡和感染。泰勒空间框架治疗为高危复杂夏科氏神经关节病足踝畸形的传统手术提供了一种替代方案。 拉霍蒂O、阿比谢蒂N、谢蒂S。使用泰勒空间框架矫正夏科氏关节病足部畸形:7至14年随访。《创伤肢体重建策略》2021年;16(2):96 - 101。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2474/8578246/3e52bfd3caf4/stlr-16-96-g001.jpg

文献AI研究员

20分钟写一篇综述,助力文献阅读效率提升50倍。

立即体验

用中文搜PubMed

大模型驱动的PubMed中文搜索引擎

马上搜索

文档翻译

学术文献翻译模型,支持多种主流文档格式。

立即体验