Armstrong D G, Pupp G R, Harkless L B
Monsignor Clement Kern Hospital for Special Surgery, Warren, MI, USA.
J Foot Ankle Surg. 1997 Sep-Oct;36(5):353-5; discussion 395-6. doi: 10.1016/s1067-2516(97)80035-x.
The purpose of this study was to evaluate the immediate postoperative morbidity, the structural correction attained, and the long-term range of motion following fixation with a single external Kirschner wire and an internal cortical screw. We abstracted records for 69 patients undergoing, distal unicorrectional chevron osteotomies. Thirty-three patients received percutaneous 0.062-inch K-wire fixation and 36 patients received single 2.7-mm. cortical screw fixation. Among these age- and sex-matched subjects, there was not a significant difference between any of the correctional or morbid outcomes measured in this study on the basis of type of fixation employed. Patients with rigid internal screw fixation did not return to shoe gear sooner, develop fewer postoperative infections, or have increased long-term range of motion than the group receiving external fixation with a single K-wire. Surgical time was significantly longer for those patients undergoing rigid internal fixation with a screw (42.5 +/- 9.5 vs. 35.1 +/- 6.6 minutes, p < 0.001). We conclude that there is no significant difference in postoperative infection, dehiscence, long-term structural correction attained, or range of motion achieved between rigid internal screws and external K-wires used to fixate distal metatarsal osteotomies.
本研究的目的是评估采用单根外用克氏针和一枚内用皮质骨螺钉固定术后的近期发病率、获得的结构矫正情况以及长期活动范围。我们提取了69例行远端单矫正性V形截骨术患者的记录。33例患者接受经皮0.062英寸克氏针固定，36例患者接受单枚2.7毫米皮质骨螺钉固定。在这些年龄和性别匹配的受试者中，基于所采用的固定类型，本研究中测量的任何矫正或发病结果之间均无显著差异。与接受单根克氏针外固定的组相比，采用刚性内螺钉固定的患者并未更快恢复穿鞋、术后感染更少或长期活动范围增加。接受螺钉刚性内固定的患者手术时间明显更长（42.5±9.5分钟对35.1±6.6分钟，p<0.001）。我们得出结论，用于固定远端跖骨截骨术的刚性内螺钉和外用克氏针在术后感染、裂开、获得的长期结构矫正或实现的活动范围方面无显著差异。
