Toporowski Gregor, Thiesen Roman, Gosheger Georg, Roedl Robert, Frommer Adrien, Laufer Andrea, Rölfing Jan Duedal, Vogt Bjoern
General Orthopaedics and Tumour Orthopaedics, Muenster University Hospital, Albert-Schweitzer-Campus 1, 48149 Muenster, Germany; Children's Orthopaedics, Deformity Correction and Foot Surgery, Muenster University Hospital, Albert-Schweitzer-Campus 1, 48149 Muenster, Germany.
General Orthopaedics and Tumour Orthopaedics, Muenster University Hospital, Albert-Schweitzer-Campus 1, 48149 Muenster, Germany; Children's Orthopaedics, Deformity Correction and Foot Surgery, Muenster University Hospital, Albert-Schweitzer-Campus 1, 48149 Muenster, Germany.
Foot Ankle Surg. 2022 Dec;28(8):1220-1228. doi: 10.1016/j.fas.2022.04.001. Epub 2022 Apr 22.
Symptomatic patients with severe brachymetatarsia are commonly treated with callus distraction using external mini-fixator (EF) or internal device (ID). This study points out advantages and limitations of both methods comparing clinical and radiographical parameters.
Retrospective analysis of 21 metatarsal bones in twelve patients. Twelve metatarsals were treated with ID (Genos Mini), nine with EF (MiniRail).
Mean lengthening distance was 17.3 mm using EF and 11.7 mm using ID (p = 0.016). Adverse results were observed in 89% of metatarsals treated with EF and in 33% treated with ID (p = 0.011). Postoperative surgical intervention was required in 33% using EF compared to 0% using ID (p = 0.031). Mean total German Foot Function Index (FFI-T) improved from 49 to 33 using EF and from 47 to 22 using ID (p < 0.001).
CD is a reliable surgical treatment for BMT. Surgeons should be aware of implant-related advantages and complications when counseling patients about treatment options.
重度跖骨短小症的症状性患者通常采用外固定微型固定器（EF）或内固定装置（ID）进行骨痂牵张治疗。本研究通过比较临床和影像学参数，指出了两种方法的优缺点。
对12例患者的21根跖骨进行回顾性分析。12根跖骨采用ID（Genos Mini）治疗，9根采用EF（MiniRail）治疗。
使用EF的平均延长距离为17.3mm，使用ID的平均延长距离为11.7mm（p = 0.016）。采用EF治疗的跖骨中有89%出现不良结果，采用ID治疗的跖骨中有33%出现不良结果（p = 0.011）。使用EF的患者中有33%需要术后手术干预，而使用ID的患者中这一比例为0%（p = 0.031）。使用EF时，平均总德国足功能指数（FFI-T）从49提高到33，使用ID时从47提高到22（p < 0.001）。
骨痂牵张术是治疗跖骨短小症的可靠手术方法。在向患者咨询治疗方案时，外科医生应了解与植入物相关的优缺点及并发症。
