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胫骨改良后跗骨化:方法与初步结果。

Modified Calcanization of Tibia for Hindfoot Defect Reconstruction: Method and Preliminary Results.

机构信息

Department of Orthopedics, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.

出版信息

Orthop Surg. 2024 Sep;16(9):2202-2210. doi: 10.1111/os.14214. Epub 2024 Aug 29.

Abstract

OBJECTIVES

To introduce our modified technique for calcanization of the tibia in managing massive bony loss of hindfoot and preliminary outcomes.

METHODS

From January 2015 to December 2021, modified calcanization of the tibia were performed in 10 patients with unilateral loss of the calcaneus. Clinical outcomes were assessed based on the American Orthopaedic Foot & Ankle Society score and Symptom Checklist-90-Revised questionnaire. Paired two-group t-test was applied to compare the parameters.

RESULTS

The mean lengthened length of the tibia was 77.3 ± 3.0 mm (range, 74-83 mm). The mean external fixation time was 123.7 ± 52.1 days (range, 117-134 days) and the mean external fixation index was 1.601 ± 0.046 days/mm. All patients stuck to the postoperative follow-up plan with an average follow-up time of 29.7 ± 3.4 months (range, 24-35 months). Deformities of the injured limbs were well corrected. Based on American Orthopaedic Foot & Ankle Society score, eight good and two fair results were achieved. The mental status of all patients was within the normal range, and several indices of the Symptom Checklist-90-Revised questionnaire of each patient were improved after the whole procedure.

CONCLUSION

We demonstrate that the modified calcanization of the tibia is qualified for total loss of calcaneus with limited complications. Early rehabilitation is attainable since external fixation time is shortened due to a simplified procedure.

摘要

目的

介绍我们改良的胫骨后移术治疗后足大块骨丢失的技术及初步结果。

方法

自 2015 年 1 月至 2021 年 12 月,对 10 例单侧跟骨缺失患者采用改良的胫骨后移术。根据美国矫形足踝协会评分(AOFAS)和症状清单-90 修订版(Symptom Checklist-90-Revised questionnaire,SCL-90-R)问卷评估临床结果。采用配对 t 检验比较参数。

结果

胫骨平均延长长度为 77.3±3.0mm(范围 74-83mm)。外固定时间平均为 123.7±52.1 天(范围 117-134 天),外固定指数平均为 1.601±0.046 天/mm。所有患者均按术后随访计划进行随访,平均随访时间为 29.7±3.4 个月(范围 24-35 个月)。患肢畸形均得到良好矫正。根据 AOFAS 评分,8 例为优,2 例为良。所有患者的精神状态均在正常范围内,且每位患者的 SCL-90-R 问卷的几个指标在整个治疗过程后均得到改善。

结论

我们证明改良的胫骨后移术适用于跟骨完全缺失,并发症少。由于手术简化,外固定时间缩短,早期康复是可行的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ae23/11572582/427f011dd029/OS-16-2202-g005.jpg

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