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采用Spherus螺钉进行距下关节制动术后有症状的柔性扁平足患者的短期和中期影像学及临床评估

Short-Term and Medium-Term Radiological and Clinical Assessment of Patients with Symptomatic Flexible Flatfoot Following Subtalar Arthroereisis with Spherus Screw.

作者信息

Bobiński Andrzej, Tomczyk Łukasz, Reichert Paweł, Morasiewicz Piotr

机构信息

Department of Orthopaedic and Trauma Surgery, Institute of Medical Sciences, University of Opole, Witosa 26, 45-401 Opole, Poland.

Department of Food Safety and Quality Management, Poznan University of Life Sciences, Wojska Polskiego 28, 60-637 Poznan, Poland.

出版信息

J Clin Med. 2023 Jul 31;12(15):5038. doi: 10.3390/jcm12155038.

Abstract

BACKGROUND

There have been no reports on arthroereisis screw insertion into the talus in patients with flexible flatfoot. We aimed to conduct a clinical and radiological assessment in patients with symptomatic pes planovalgus deformity treated with a talar screw.

METHODS

This study involved a prospective assessment of 27 patients treated surgically for symptomatic flexible flatfoot deformity in the period 2021-2022. The following parameters were assessed in this study: Meary's angle, the Costa-Bartani angle, the calcaneal pitch angle, surgery duration, the length of hospital stay, patient satisfaction, patients' retrospective willingness to consent to the treatment they received, postoperative complications, and the use of analgesics.

RESULTS

The mean follow-up period was 14.76 months. Meary's angle decreased from 18.63° before surgery to 9.39° at follow-up ( = 0.004). The Costa-Bartani angle decreased significantly from 154.66° before surgery to 144.58° after surgery ( = 0.012). The calcaneal pitch angle changed from 16.21° before to 19.74°. Complications were reported in three patients (11.11%). The mean surgery duration was 32 min. The mean hospital stay was 2.2 days. Fourteen patients (51.85%) were highly satisfied with the treatment, and 12 patients (44.44%) were quite satisfied with treatment. Twenty-five (92.59%) of the evaluated patients would choose the same type of treatment again. Six patients (22.22%) needed to use analgesics prior to surgical treatment, whereas none of the patients needed to use them by the final follow-up.

CONCLUSION

Spherus screw arthroereisis helps improve radiological parameters in patients with flexible flatfoot. We observed good clinical outcomes after treatment with a talar screw, with a majority of patients reporting moderate-to-high levels of satisfaction with treatment. Both short- and medium-term treatment outcomes of pes planovalgus treatment with the use of Spherus screw are good.

摘要

背景

对于柔韧性扁平足患者,尚无关于距骨插入关节制动螺钉的报道。我们旨在对接受距骨螺钉治疗的有症状扁平外翻足畸形患者进行临床和影像学评估。

方法

本研究对2021年至2022年期间因有症状的柔韧性扁平足畸形接受手术治疗的27例患者进行了前瞻性评估。本研究评估了以下参数:梅里角、科斯塔 - 巴尔塔尼角、跟骨倾斜角、手术时长、住院时间、患者满意度、患者对所接受治疗的回顾性同意意愿、术后并发症以及镇痛药的使用情况。

结果

平均随访期为14.76个月。梅里角从术前的18.63°降至随访时的9.39°(P = 0.004)。科斯塔 - 巴尔塔尼角从术前的154.66°显著降至术后的144.58°(P = 0.012)。跟骨倾斜角从术前的16.21°变为19.74°。3例患者(11.11%)报告有并发症。平均手术时长为32分钟。平均住院时间为2.2天。14例患者(51.85%)对治疗高度满意,12例患者(44.44%)对治疗相当满意。25例(92.59%)接受评估的患者会再次选择相同类型的治疗。6例患者(22.22%)在手术治疗前需要使用镇痛药,而到最终随访时,没有患者需要使用镇痛药。

结论

球形螺钉关节制动有助于改善柔韧性扁平足患者的影像学参数。我们观察到距骨螺钉治疗后临床效果良好,大多数患者对治疗的满意度为中到高。使用球形螺钉治疗扁平外翻足的短期和中期治疗效果均良好。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/92fe/10420212/9895f8e217c1/jcm-12-05038-g001.jpg

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