移位性关节内跟骨骨折后创伤性距下关节融合术不愈合的相关因素。

Factors associated with nonunion of the posttraumatic subtalar arthrodesis after displaced intra-articular calcaneal fractures.

作者信息

Kang Suk-Woong, Jung Sung Won, Woo Seung Hun

机构信息

Department of Orthopaedic Surgery, Pusan National University School of Medicine, Yangsan, the Republic of Korea.

出版信息

Foot Ankle Surg. 2023 Apr;29(3):188-194. doi: 10.1016/j.fas.2022.12.005. Epub 2022 Dec 14.

DOI:10.1016/j.fas.2022.12.005

PMID:36732154

Abstract

BACKGROUND

This study investigated the incidence of and risk factors for nonunion in patients with posttraumatic subtalar arthrodesis (SA).

METHODS

We retrospectively reviewed 165 posttraumatic SA cases. Nonunion was diagnosed at 6 months after surgery based on the findings of clinical evaluations, plain radiographs, and CT scans. Patient-specific factors and surgeon-specific factors were evaluated as potential risk factors.

RESULTS

The overall nonunion rate was 13.3 % (22 of 165 cases). In the final multivariate logistic regression analysis, smoking (odds ratio [OR] = 3.64; 95 % confidence interval [CI] = 1.23-10.75), parallel screw configuration (OR = 5.70; 95 % CI = 1.62-20.06), and freeze dried iliac crest (OR = 9.16; 95 % CI = 2.28-36.79) were demonstrated as risk factors for nonunion of posttraumatic SA.

CONCLUSION

Patients with a history of smoking, parallel screw configuration fixation, and those who received freeze dried iliac crest as an interpositional graft, had a significantly higher rate of nonunion.

摘要

背景

本研究调查创伤后距下关节融合术（SA）患者骨不连的发生率及危险因素。

方法

我们回顾性分析了165例创伤后SA病例。根据临床评估、X线平片和CT扫描结果，在术后6个月诊断骨不连。评估患者特异性因素和外科医生特异性因素作为潜在危险因素。

结果

总体骨不连率为13.3%（165例中的22例）。在最终的多因素逻辑回归分析中，吸烟（比值比[OR]=3.64；95%置信区间[CI]=1.23 - 10.75）、平行螺钉构型（OR=5.70；95%CI=1.62 - 20.06）和冻干髂嵴（OR=9.16；95%CI=2.28 - 36.79）被证明是创伤后SA骨不连的危险因素。