Coastal Podiatry, Virginia Beach, VA.
Foot Care Specialist, Lee's Summit, MO.
J Foot Ankle Surg. 2023 Sep-Oct;62(5):877-882. doi: 10.1053/j.jfas.2023.06.001. Epub 2023 Jun 20.
Collapsing foot deformity (CFD) and its resulting sequelae caused by recurring talotarsal joint dislocation (RTTJD) affects pediatric and adult patients. An extraosseous talotarsal stabilization (EOTTS) procedure, a subset of subtalar arthroereisis (SA) procedures, is recommended as a minimally invasive, first in-line surgical treatment option for CFD. The aim of this multicenter, retrospective study was to evaluate patient-reported outcomes measures in patients who were treated for RTTJD with Type II EOTTS implants. Sixty-seven cases having a median age of 38 years (range: 10-74) with more than 5 years of follow-up were included in this study. The mean postoperative visual analog scale and Maryland Foot Score was 1.0 ± 1.9 and 92.3 ± 11.3, respectively, indicating excellent clinical outcomes. Subjectively, 88% cases reported as being satisfied with the outcome, 94% cases said they would recommend EOTTS, and 93% said that, if necessary, they would repeat it on their contralateral foot. A subgroup analysis revealed that while not statistically significant, clinical outcomes were slightly better in pediatric patients compared to adults. Implant removal rate was 4.5% (3 cases), and these were in the adult group only. Rate of minor issues such as pain, stiffness, discomfort, etc. was 15%; however, no serious adverse effects or complications were observed in any patient. This study suggests that EOTTS is an effective surgical treatment option wherein successful long-term clinical outcomes with low failure rates can be achieved in a select patient population.
跟骨塌陷性足畸形(CFD)及其继发的反复距跟关节脱位(RTTJD)影响小儿和成人患者。一种称为跗骨间外固定术(EOTTS)的手术,是距下关节融合术(SA)的一种亚类,被推荐为 CFD 的一种微创、一线手术治疗选择。本多中心回顾性研究旨在评估接受 II 型 EOTTS 植入物治疗 RTTJD 的患者的患者报告结局测量指标。本研究纳入了 67 例患者,中位年龄为 38 岁(范围:10-74 岁),随访时间超过 5 年。术后平均视觉模拟评分和马里兰州足部评分分别为 1.0±1.9 和 92.3±11.3,表明临床结果极佳。主观上,88%的病例对结果表示满意,94%的病例表示会推荐 EOTTS,93%的病例表示如果有必要,他们会在对侧脚上重复该手术。亚组分析显示,虽然无统计学意义,但与成人相比,儿童患者的临床结果略好。植入物取出率为 4.5%(3 例),且均发生在成人组。轻微问题(如疼痛、僵硬、不适等)的发生率为 15%;然而,在任何患者中均未观察到严重不良事件或并发症。本研究表明,EOTTS 是一种有效的手术治疗选择,在特定患者群体中可以实现长期成功且失败率低的临床结果。