Döring Kevin, Apprich Sebastian, Hanna Markus, Windhager Reinhard, Puchner Stephan
Department of Orthopedics and Trauma Surgery, Medical University of Vienna, 1090 Vienna, Austria.
J Clin Med. 2024 Sep 23;13(18):5628. doi: 10.3390/jcm13185628.
In comparison to titanium screws, novel cortical bone allograft screws may come with advantages in osseointegration and with avoidance of potential material removal surgery after scarf osteotomy. A scarf osteotomy with allograft bone screws as fixation was performed in 21 patients (30 feet). Clinical and radiological parameters were prospectively collected until one year after surgery. A retrospective control group, consisting of 75 patients (82 feet) after scarf osteotomy using headless compression screws, was used to compare clinical outcomes. After fixation with allograft bone screws, the mean preoperative AOFAS score increased from 51.5 points preoperatively to 93.5 points one year after surgery. In radiological assessments, a continuous osseointegration with the remodeling of the bone screw was observed in all patients that finished follow-up. However, four metatarsal fractures occurred early postoperatively after fixation using allograft bone screws. There were only three material removal surgeries in patients treated with headless compression screws. : Allograft bone screws display a safe fixation and are a biological alternative for scarf osteotomy. Enough distance between the screw and the proximal osteotomy should be ensured to avoid fractures.
与钛螺钉相比，新型皮质骨同种异体移植螺钉在骨整合方面可能具有优势，并且可以避免在斜行截骨术后进行潜在的取出材料手术。对21例患者（30足）进行了采用同种异体移植骨螺钉固定的斜行截骨术。前瞻性收集临床和影像学参数直至术后一年。采用一个回顾性对照组，该组由75例患者（82足）组成，这些患者在斜行截骨术后使用无头加压螺钉，用于比较临床结果。采用同种异体移植骨螺钉固定后，术前美国足踝外科协会（AOFAS）平均评分从术前的51.5分提高到术后一年的93.5分。在影像学评估中，所有完成随访的患者均观察到骨螺钉重塑的连续性骨整合。然而，采用同种异体移植骨螺钉固定后，术后早期发生了4例跖骨骨折。使用无头加压螺钉治疗的患者仅进行了3次取出材料手术。同种异体移植骨螺钉显示出安全的固定效果，是斜行截骨术的一种生物替代方案。应确保螺钉与近端截骨处之间有足够的距离以避免骨折。
