术前溃疡对胫距跟关节融合术的疗效无影响。
No effect of preoperative ulceration on outcomes of tibiotalocalcaneal arthrodesis.
作者信息
Newton William N, Hoch Caroline, Gross Christopher E, Scott Daniel
机构信息
Medical University of South Carolina, Department of Orthopaedics and Physical Medicine, 96 Jonathan Lucas Street, CSB 708, MSC 622, Charleston, SC 29425, USA.
Medical University of South Carolina, Department of Orthopaedics and Physical Medicine, 96 Jonathan Lucas Street, CSB 708, MSC 622, Charleston, SC 29425, USA.
出版信息
Foot Ankle Surg. 2022 Dec;28(8):1235-1238. doi: 10.1016/j.fas.2022.04.004. Epub 2022 May 2.
BACKGROUND
Tibiotalocalcaneal (TTC) arthrodesis is a commonly performed operation for complex hindfoot pathology, but the effect of preoperative ulceration on TTC outcomes has been debated. This study aims to examine infection rates in patients undergoing TTC arthrodesis with internal fixation with and without concomitant hindfoot ulceration.
METHODS
We conducted a retrospective review of 31 patients who underwent a TTC arthrodesis between June 2016 and February 2021 with a fellowship-trained foot and ankle surgeon at an academic medical center. Nine (29.0%) patients had preoperative ulceration. Mean follow-up duration was 1.49 (range, 0.51-4.28) years. Other data collected included demographics, comorbidities, surgical approach, fixation method, and complication and reoperation rates.
RESULTS
There was no difference in overall complication (ulcer [U]=66.7%, no ulcer [NU]=50.0%; p = .397), infection (U=33.3%, NU=31.8%; p = .935), or reoperation (U=55.6%, NU=27.3%; p = .135) rates between groups.
CONCLUSIONS
TTC arthrodesis with internal fixation appears to be a reasonable treatment method for patients with a preoperative ulcer.
背景
胫距跟关节融合术是治疗复杂后足病变的常见手术，但术前溃疡对胫距跟关节融合术疗效的影响一直存在争议。本研究旨在探讨接受内固定的胫距跟关节融合术患者，无论是否伴有后足溃疡，其感染率情况。
方法
我们对2016年6月至2021年2月期间在一所学术医疗中心，由一位接受过足踝专科培训的外科医生进行胫距跟关节融合术的31例患者进行了回顾性研究。其中9例（29.0%）患者有术前溃疡。平均随访时间为1.49年（范围0.51 - 4.28年）。收集的其他数据包括人口统计学资料、合并症、手术入路、固定方法以及并发症和再次手术率。
结果
两组之间在总体并发症（溃疡组[U]=66.7%，无溃疡组[NU]=50.0%；p = 0.397）、感染（U=33.3%，NU=31.8%；p = 0.935）或再次手术（U=55.6%，NU=27.3%；p = 0.135）发生率方面无差异。
结论
对于术前有溃疡的患者，内固定胫距跟关节融合术似乎是一种合理的治疗方法。
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