距骨前过长和骨软骨损伤：是否存在解剖学倾向？135 例病例对照研究。
The too-long anterior process and osteochondral lesion of the talus: Is there an anatomical predisposition? A case-control study on 135 feet.
机构信息
Department of Paediatric Surgery and Orthopaedics, Jeanne de Flandre Hospital, Lille University Hospital, Lille, France.
Orthopaedic Clinic, Departement of Surgery and Translational Medecine, University of Florence, Florence, Italy.
出版信息
Foot Ankle Surg. 2022 Oct;28(7):1076-1082. doi: 10.1016/j.fas.2022.03.002. Epub 2022 Mar 9.
INTRODUCTION
The too-long anterior process (TLAP) increases mechanical stress on the hindfoot and could lead to osteochondral lesions of the talus (OLT) by localized hyper-pressure. The purpose of this study is to investigate an association between TLAP and OLT in children.
METHODS
This is a retrospective, multicenter, case-control study conducted between 2010 and 2020. The OLT group was compared to a control group (CoG). TLAP is characterized by a distance between the anteromedial process of the calcaneus and the navicular bone (CN) of< 5 mm.
RESULTS
Forty-three feets were included in the OLT group and 92 in the CoG. The OLT group had a lower CN distance on CT than the CoG, a median of 2.8 mm versus 3.75 mm (p = 0.002); 86% of patients (37 feet/43) in the OLT group had a CN distance of< 5 mm (OR=3.0 [1.1; 9.5], p = 0.023) compared to 67% in the CoG.
DISCUSSION
The OLT group had an increased risk of developing TLAP compared to the CoG.
LEVEL OF EVIDENCE
III.
简介
过长的前距骨突（TLAP）会增加后足的机械应力，并可能通过局部高压导致距骨骨软骨损伤（OLT）。本研究旨在探讨 TLAP 与儿童 OLT 之间的关联。
方法
这是一项回顾性、多中心、病例对照研究，于 2010 年至 2020 年期间进行。OLT 组与对照组（CoG）进行比较。TLAP 的特征是跟骨前内侧突与舟骨之间的距离<5mm。
结果
OLT 组有 43 只脚，CoG 组有 92 只脚。OLT 组 CT 上的 CN 距离比 CoG 组低，中位数为 2.8mm 对 3.75mm（p=0.002）；OLT 组中 86%的患者（37 只脚/43 只）的 CN 距离<5mm（OR=3.0[1.1; 9.5]，p=0.023），而 CoG 组中为 67%。
讨论
与 CoG 相比，OLT 组发生 TLAP 的风险增加。
证据等级
III。
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