埃文斯无固定物截骨术后,骨不连和钙丘脱位的发生率极低。

Solangel Rodriguez-Materon, Megan Miles, Nigel Hsu, Brian Gallagher, Gregory Guyton
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引用次数: 0

摘要

背景:在没有数据支持的情况下,人们一直主张对埃文斯截骨术进行固定以矫正扁平足,从而促进骨结合并避免小方块半脱位。我们在迄今为止报道的最大规模的埃文斯手术系列中对这些问题进行了研究:方法:在一个连续的系列中,共有137名患者接受了埃文斯截骨术,其中118例由一名外科医生进行了无固定手术。平均随访时间为 62.5 周。对骨结合情况和包括小关节半脱位在内的影像学测量结果进行了评估:结果:117/118 例(99.2%)骨结合。与术前值(1.5 ± 2.3 mm)相比,钙丘半脱位的增加幅度很小。平均楔形尺寸为 7.1 ± 1.4 毫米。纵弓的所有影像学测量结果均有所改善:结论:埃文斯无固定截骨术显示了近乎完全的结合和最小的小方块半脱位。在我们的系列研究中,由于经常使用额外的截骨术,因此可以使用较小的楔形截骨,这也是我们取得良好结果的原因之一:4.
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Nonunion and Calcaneocuboid Subluxation Are Minimal After Evans Osteotomy Without Fixation.

Background: Fixation of the Evans osteotomy for flatfoot correction has been advocated without supporting data to facilitate union and avoid calcaneocuboid subluxation. We examined these issues in the largest reported series of Evans procedures to date.

Methods: A total of 118 cases from a consecutive series of 137 patients who underwent Evans osteotomy without fixation by a single surgeon were available for review. Average follow-up was 62.5 weeks. Bony union and radiographic measurements including calcaneocuboid subluxation were evaluated.

Results: Union occurred in 117/118 cases (99.2%). Calcaneocuboid subluxation increased minimally compared to preoperative values (1.5 ± 2.3 mm). The mean wedge size was 7.1 ± 1.4 mm. All radiographic measurements of the longitudinal arch improved.

Conclusion: The Evans osteotomy without fixation demonstrated near-universal union and minimal calcaneocuboid subluxation. The frequent use of additional osteotomies in our series might have allowed the use of smaller wedges and contributed to our favorable results.

Level of evidence: 4.

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