deMeireles Alirio J, Guzman Javier Z, Nordio Andrea, Chan Jimmy, Okewunmi Jeffrey, Vulcano Ettore
Department of Orthopaedic Surgery, Columbia University Irving Medical Center, New York, NY, USA.
Leni & Peter W. May Department of Orthopedic Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Foot Ankle Orthop. 2022 Aug 23;7(3):24730114221119731. doi: 10.1177/24730114221119731. eCollection 2022 Jul.
Open hindfoot surgery is associated with a relatively high rate of complications, including neurovascular injuries and wound healing problems compared with percutaneous techniques. However, there is a scarcity of literature describing the outcomes of these percutaneous techniques given their relatively recent adoption. The present study aims to assess the rate of postoperative complications for 3 commonly performed percutaneous calcaneal osteotomies.
One hundred eighteen patients (unilateral feet) were treated with one of 3 common percutaneous calcaneal osteotomies. Sixty-five patients (55.1%) were treated with a medializing calcaneal osteotomy for hindfoot valgus, 32 patients with a Zadek osteotomy (27.1%) for insertional Achilles tendinopathy, and 21 patients (17.8%) with a modified Dwyer osteotomy for hindfoot varus. Fisher exact test was used to assess for associations between categorical variables.
The mean age was 46.2 years and there was a mean follow-up of 16.1 months. The overall rate of postoperative complications was 3.4% (n = 4), and no significant differences were found between the different osteotomy types. Complications included 2 cases (1.7%) of transient neuritis, 1 case of prolonged wound drainage (0.8%), and 1 nonunion (0.8%). None of the complications were associated with any recorded preoperative comorbidity.
In this series, we found that percutaneous calcaneal osteotomies are a safe alternative method for the treatment of conditions involving the hindfoot. The rate of postoperative complications may be less when compared to the reported rates of open hindfoot correction and should be considered in patients with a traditionally high risk of developing a postoperative complication.
Level IV, retrospective analysis.
与经皮技术相比，开放性后足手术并发症发生率相对较高，包括神经血管损伤和伤口愈合问题。然而，鉴于这些经皮技术应用时间相对较短，描述其治疗效果的文献较少。本研究旨在评估3种常见的经皮跟骨截骨术的术后并发症发生率。
118例患者（单侧足部）接受了3种常见经皮跟骨截骨术之一的治疗。65例（55.1%）患者因后足外翻接受跟骨内移截骨术，32例（27.1%）患者因跟腱止点性肌腱病接受扎德克截骨术，21例（17.8%）患者因后足内翻接受改良德怀尔截骨术。采用Fisher精确检验评估分类变量之间的相关性。
患者平均年龄为46.岁，平均随访16.1个月。术后并发症总发生率为3.4%（n = 4），不同截骨术式之间未发现显著差异。并发症包括2例（1.7%）短暂性神经炎、1例伤口引流时间延长（0.8%）和1例骨不连（0.8%）。所有并发症均与术前记录的任何合并症无关。
在本系列研究中，我们发现经皮跟骨截骨术是治疗后足疾病的一种安全替代方法。与开放性后足矫正术的报告发生率相比，术后并发症发生率可能更低，对于传统上术后并发症发生风险较高的患者应考虑采用该方法。
IV级，回顾性分析。
