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足、踝及小腿骨不连的治疗:一项比较传统治疗与同种异体皮质骨螺钉(鲨鱼螺钉)的多中心回顾性研究

Non-Union Treatment in the Foot, Ankle, and Lower Leg: A Multicenter Retrospective Study Comparing Conventional Treatment with the Human Allogeneic Cortical Bone Screw (Shark Screw).

作者信息

Labmayr Viktor, Huber Elisabeth, Wenzel-Schwarz Florian, Holweg Patrick, Ornig Martin, Jakob Gerd, Palle Wolfgang, Borchert Gudrun H, Pastl Klaus

机构信息

Department of Orthopaedics and Trauma, Medical University Graz, Auenbruggerplatz 5, A-8036 Graz, Austria.

DOKH Friesach, St Veit Str. 12, A-9360 Friesach, Austria.

出版信息

J Pers Med. 2024 Mar 27;14(4):352. doi: 10.3390/jpm14040352.

Abstract

Addressing non-unions involves stabilizing the affected area through osteosynthesis and improving bone biology using bone grafts. However, there is no consensus on the optimal treatment method. This study aims to compare outcomes of non-union surgery using conventional treatment methods (metal hardware ± graft) versus osteosynthesis with the human allogeneic cortical bone screw (Shark Screw) alone or in combination with a metallic plate. Thirty-four patients underwent conventional treatment, while twenty-eight cases received one or more Shark Screws. Patient demographics, bone healing, time to bone healing, and complications were assessed. Results revealed a healing rate of 96.4% for the Shark Screw group, compared to 82.3% for the conventionally treated group. The Shark Screw group exhibited a tendency for faster bone healing (9.4 ± 3.2 vs. 12.9 ± 8.5 weeks, = 0.05061). Hardware irritations led to six metal removals in the conventional group versus two in the Shark Screw group. The Shark Screw emerges as a promising option for personalized non-union treatment in the foot, ankle, and select lower leg cases, facilitating effective osteosynthesis and grafting within a single construct and promoting high union rates, low complications, and a rapid healing process.

摘要

治疗骨不连包括通过骨固定术稳定患区,并使用骨移植改善骨生物学特性。然而,对于最佳治疗方法尚无共识。本研究旨在比较使用传统治疗方法(金属内固定物±植骨)与单独使用人同种异体皮质骨螺钉(鲨鱼螺钉)或与金属板联合使用进行骨不连手术的疗效。34例患者接受了传统治疗,而28例患者接受了一个或多个鲨鱼螺钉治疗。对患者的人口统计学特征、骨愈合情况、骨愈合时间和并发症进行了评估。结果显示,鲨鱼螺钉组的愈合率为96.4%,而传统治疗组为82.3%。鲨鱼螺钉组显示出骨愈合更快的趋势(9.4±3.2周对12.9±8.5周,P = 0.05061)。传统组有6例因内固定物刺激而取出金属内固定物,而鲨鱼螺钉组为2例。对于足部、踝关节和部分小腿病例的个性化骨不连治疗,鲨鱼螺钉是一个有前景的选择,它能在单一结构内实现有效的骨固定和植骨,促进高愈合率、低并发症和快速愈合过程。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d876/11051244/65a281283434/jpm-14-00352-g001.jpg

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