Huber Thorsten, Hofstätter Stefan G, Fiala Rainer, Hartenbach Florian, Breuer Robert, Rath Björn
Department of Orthopedics and Trauma Surgery, Klinikum Wels-Grieskirchen, 4600 Wels, Austria.
Independent Researcher, 4600 Wels, Austria.
J Clin Med. 2022 Mar 3;11(5):1384. doi: 10.3390/jcm11051384.
Background: Distal first metatarsal osteotomies are commonly performed operative procedures for hallux valgus deformity, and usually involve fixation with a metal screw. However, various bioabsorbable osteosynthesis materials have been in use for a number of years. One recent innovation is the Shark Screw®, a human cortical bone allograft. This study aimed to evaluate the efficacy and safety of this allogeneic screw in the stabilization of Reversed L-Shaped osteotomy, a modified Chevron osteotomy. Methods: In a prospective study, 15 patients underwent a Reversed L-Shaped osteotomy stabilized with the allogenic bone screw Radiological data on osteointegration of the screw and correction of the intermetatarsal angle were recorded. Furthermore, each follow-up examination included the collection of clinical data, the American Orthopedic Foot and Ankle Society (AOFAS) score, evaluation of pain level, and patient’s overall satisfaction. Results: Full osseous fusion of the osteotomy was seen in all patients. The bone screws were radiographically integrated after approximately 6.5 (±2.6) months. Neither nonunion nor failure occurred in any of our cases. Furthermore, we did not find any potential graft reaction. The AOFAS score improved significantly from 51.6 (±15.2) points to 90.9 (±10.3) (p < 0.001). The preoperative hallux valgus angle and intermetatarsal angle decreased significantly from 24.8 (±4.9) degrees to 7.2 (±4.4) degrees (p < 0.001) and 12.6 (±3.2) degrees to 4.8 (±1.3) degrees (p < 0.001), respectively. Conclusions: With this study, we demonstrated the efficiency of the allogenic bone screw (Shark Screw®) in regard to clinical and radiological short-term outcomes.
第一跖骨远端截骨术是治疗拇外翻畸形常用的手术方法，通常采用金属螺钉固定。然而，多种生物可吸收骨合成材料已使用多年。最近的一项创新是鲨鱼螺钉（Shark Screw®），一种人皮质骨同种异体移植物。本研究旨在评估这种同种异体螺钉在改良的 Chevron 截骨术即反向 L 形截骨术稳定中的有效性和安全性。方法：在一项前瞻性研究中，15 例患者接受了使用同种异体骨螺钉固定的反向 L 形截骨术。记录了螺钉骨整合及跖间角矫正的放射学数据。此外，每次随访检查包括收集临床数据、美国矫形足踝协会（AOFAS）评分、疼痛程度评估和患者总体满意度。结果：所有患者截骨处均实现完全骨融合。放射学显示骨螺钉在约 6.5（±2.6）个月后实现整合。我们的病例中均未发生骨不连或失败情况。此外，我们未发现任何潜在的移植物反应。AOFAS 评分从 51.6（±15.2）分显著提高至 90.9（±10.3）分（p < 0.001）。术前拇外翻角和跖间角分别从 24.8（±4.9）度显著降至 7.2（±4.4）度（p < 0.001）和从 12.6（±3.2）度降至 4.8（±1.3）度（p < 0.001）。结论：通过本研究，我们证明了同种异体骨螺钉（鲨鱼螺钉®）在临床和放射学短期疗效方面的有效性。
