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Visualizing access in pilon fractures: A comparative study of eight approaches 枕部骨折的可视化通路:八种入路的比较研究。
IF 2 3区 医学 Q2 ORTHOPEDICS Pub Date : 2025-08-01 DOI: 10.1016/j.fas.2025.02.009
Tomas Urrutia, Jorge Faundez, Catalina Vidal, Joaquín Palma, Jorge Filippi

Background

Pilon fractures, constituting 3–10 % of all tibia fractures, present significant challenges due to their complex nature and frequent involvement of soft tissue damage. Effective management necessitates careful preoperative planning and strategic surgical approach selection. This study aims to provide a comprehensive cadaveric analysis comparing eight distinct surgical approaches to tibial pilon fractures, focusing on the consistently exposed segment and the extent of the exposed bone area for each approach.

Methods

Sixteen foot and ankle specimens, obtained through our university's body donation program, were utilized for this study. Each specimen underwent two different approaches, resulting in four repetitions for each assessed method. The approaches analyzed included anteromedial, anterolateral, lateral, posterolateral, posteromedial, posterior modified posteromedial, anterior modified posteromedial, and medial approaches. Standardized incisions and retraction techniques were employed to measure the exposed bone area using ImageJ software, while the consistently exposed segment was determined through axial cuts and photographic analysis.

Results

The anteromedial approach yielded the largest exposed area (18.36 cm²), whereas the anterolateral approach provided the greatest exposed segment (72°). The posteromedial approach proved most effective for exposing the Volkmann fragment, and the anterolateral approach was optimal for accessing the Chaput fragment and comminution areas. Combining the posteromedial and posterior modified posteromedial approaches could be suggested for extensive posterior malleolus fractures to maximize bone surface exposure while minimizing soft tissue damage.

Conclusion

This study offers objective data on the exposed area and segment for various surgical approaches, providing a valuable resource for orthopedic surgeons in preoperative planning and decision-making. By enhancing the understanding of the capabilities and limitations of each approach, this research aims to improve surgical outcomes for patients with complex tibial pilon fractures.
背景:皮隆骨折,占所有胫骨骨折的3- 10% %,由于其复杂的性质和频繁涉及软组织损伤,提出了重大挑战。有效的治疗需要仔细的术前计划和策略性的手术入路选择。本研究旨在提供全面的尸体分析,比较8种不同的手术入路治疗胫骨pilon骨折,重点关注每种入路的持续暴露段和暴露骨面积的程度。方法:利用我校遗体捐献项目获得的16例足部和踝关节标本进行研究。每个标本经历了两种不同的方法,导致每种评估方法重复四次。分析的入路包括前内侧入路、前外侧入路、外侧入路、后外侧入路、后内侧入路、后内侧入路、前内侧入路和内侧入路。使用ImageJ软件采用标准化切口和内收技术测量暴露骨面积,通过轴向切口和摄影分析确定一致暴露的骨段。结果:前内侧入路暴露面积最大(18.36 cm²),前外侧入路暴露面积最大(72°)。后内侧入路对于暴露Volkmann碎片最为有效,而前外侧入路对于接触Chaput碎片和粉碎区最为理想。后内侧入路和后路改良后内侧入路联合应用于广泛后踝骨折,可最大限度地暴露骨面,同时减少软组织损伤。结论:本研究为各种手术入路的暴露区域和暴露段提供了客观的数据,为骨科医生的术前规划和决策提供了宝贵的资源。通过加深对每种入路的能力和局限性的了解,本研究旨在改善复杂胫骨pilon骨折患者的手术效果。
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引用次数: 0
Letter to the editor to comment on: Prevalence and risk factors of ankle osteoarthritis in a population-based study 一项人群研究中踝关节骨关节炎的患病率和风险因素:评论。
IF 2 3区 医学 Q2 ORTHOPEDICS Pub Date : 2025-08-01 DOI: 10.1016/j.fas.2024.09.006
Katherine Ning Li
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引用次数: 0
The influence of cell and platelet number on clinical outcomes provided by a one-step scaffold transplantation with bone marrow concentrate for the treatment of osteochondral lesions of the talus 细胞和血小板数量对骨髓浓缩一步支架移植治疗距骨软骨病变临床结果的影响
IF 2 3区 医学 Q2 ORTHOPEDICS Pub Date : 2025-08-01 DOI: 10.1016/j.fas.2025.01.014
Luca Berveglieri , Francesca Vannini , Laura Ramponi , Angelo Boffa , Carola Cavallo , Annarita Cenacchi , Giuseppe Filardo , Roberto Buda , Cesare Faldini

Purpose

The aim of this study was to investigate if the numbers of cells and platelets in the bone marrow aspirate concentrate (BMAC) added to a hyaluronic acid membrane influence the clinical outcome up to long-term follow-up in the treatment of osteochondral lesions of the talus (OLTs).

Methods

A total of 102 patients with symptomatic OLTs underwent this one-step treatment. Eighty-five patients (53 men, 32 women, age 32.3 ± 10.6 years, lesion size 2.7 ± 1.6 cm2) were prospectively evaluated at baseline and at 2–5–10 years using the AOFAS ankle-hindfoot score, the NRS for pain, and the Tegner score. Satisfaction and failures were documented as well. Laboratory analysis of BMAC was performed for the count of mononucleated cells (MNCs) and platelets.

Results

The AOFAS improved from baseline (59.1 ± 13.7) to the final follow-up (82.3 ± 14.9, p < 0.0005). NRS improved from 7.1 ± 1.1 at baseline to 3.9 ± 2.8 at the final follow-up (p < 0.0005). Tegner improved from a pre-op 2.0 median to 3.0 at the final follow-up (p < 0.0005), not reaching the pre-injury level. MNCs and platelets in BMAC were 148.2 ± 54.2 × 109/L and 454.3 ± 277.5 × 109/L, respectively. MNCs correlated with NRS at 2 years (p = 0.018; rho=-0.260). However, MNCs number, as well as platelet number, did not influence the improvement from baseline of the clinical scores at all follow-up evaluations.

Conclusion

This study demonstrated, in a large series of patients evaluated up to a long-term follow-up, that the number of MNCs and platelets present in BMAC does not influence the overall clinical outcomes in patients affected by OLTs treated with a one-step hyaluronic acid scaffold implantation augmented with BMAC.

Level of evidence

IV.
目的:本研究的目的是探讨加入透明质酸膜的骨髓抽液浓缩液(BMAC)中细胞和血小板的数量是否影响距骨软骨病变(OLTs)治疗的长期随访的临床结果。方法:102例有症状的olt患者采用此一步法治疗。85例患者(男性53例,女性32例,年龄32.3 ± 10.6岁,病变大小2.7 ± 1.6 cm2)在基线和2-5-10年时使用AOFAS踝关节-后足评分、疼痛NRS评分和Tegner评分进行前瞻性评估。满意和失败也被记录下来。实验室分析BMAC对单核细胞(MNCs)和血小板的计数。结果:AOFAS改善从基线(59.1 ±13.7 )最后的随访(82.3 ± 14.9,p 9 / L和454.3 ±277.5  × 109 / L,分别。跨国公司与2年NRS相关(p = 0.018;ρ= -0.260)。然而,在所有随访评估中,跨国公司数量以及血小板数量并不影响临床评分较基线的改善。结论:本研究表明,在对大量患者进行长期随访评估后,BMAC中存在的MNCs和血小板数量不会影响接受BMAC增强的一步透明质酸支架植入治疗的olt患者的总体临床结果。证据等级:四级。
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引用次数: 0
Visual analog scale foot and ankle (VAS-FA): Reliability and validity of the Persian version 视觉模拟脚和脚踝量表(VAS-FA):波斯版本的信度和效度。
IF 2 3区 医学 Q2 ORTHOPEDICS Pub Date : 2025-08-01 DOI: 10.1016/j.fas.2025.02.004
Hooshmand Zarei , Miad Nosratpour , Seyed Mohammadmisagh Moteshakereh , Mahyar Mahdavi , Amir Sabaghzadeh

Background

Our purpose was to evaluate the reliability and validity of the Persian version of the visual analog scale foot and ankle (VAS-FA) among patients with foot and ankle problems and healthy subjects.

Methods

The VAS-FA was translated and adapted into Persian (Farsi). Then, 82 participants, including 41 healthy subjects and 41 patients with foot and ankle problems, fulfilled the questionnaire in two sessions. The validity was assessed by correlating VAS-FA with the Persian version of the foot and ankle outcome score (FAOS) and the foot and ankle ability measure (FAAM). Intraclass correlation coefficient (ICC) and Cronbach's α were used to assess test-retest reliability and internal consistency.

Results

There was a statistically significant difference between healthy participants and patients regarding the total VAS-FA score and its subscales (P < 0.001). The test-retest reliability was excellent, and the internal consistency was good to excellent. The correlation between the total VAS-FA score and FAAM and FAOS scores was good for the healthy subjects and good to excellent for patients.

Conclusion

The Persian version of VAS-FA is valid and reliable.
背景:我们的目的是评估波斯版足踝关节视觉模拟量表(VAS-FA)在足踝关节问题患者和健康受试者中的信度和效度。方法:将VAS-FA翻译成波斯语。然后,82名参与者,包括41名健康受试者和41名足部和踝关节问题患者,分两次完成问卷调查。通过将VAS-FA与波斯版足踝关节结局评分(FAOS)和足踝关节能力测量(FAAM)相关联来评估有效性。采用类内相关系数(ICC)和Cronbach’s α评价重测信度和内部一致性。结果:健康受试者与患者在VAS-FA总分及其亚量表上的差异有统计学意义(P )。结论:波斯版VAS-FA量表是有效可靠的。
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引用次数: 0
Letter to the editor to comment on “A comparative biomechanical study of the krackow suture technique with three common percutaneous suture techniques in the treatment of Achilles tendon ruptures” 针对 "Zeybek H、Cici H、Çıklaçandır S.在治疗跟腱断裂时克拉克洛缝合技术与三种常见经皮缝合技术的生物力学比较研究"[Foot Ankle Surg. 30 (2024) 366-370]。
IF 2 3区 医学 Q2 ORTHOPEDICS Pub Date : 2025-08-01 DOI: 10.1016/j.fas.2024.08.005
Nicola Maffulli, Filippo Spiezia,
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引用次数: 0
Impact of symptomatic deep vein thrombosis on self-reported function and treatment outcome following an acute Achilles tendon rupture: A register study 急性跟腱断裂后症状性深静脉血栓对自我报告功能和治疗结果的影响:一项登记研究
IF 2 3区 医学 Q2 ORTHOPEDICS Pub Date : 2025-08-01 DOI: 10.1016/j.fas.2025.02.002
Jacob S. Gandløse , Kristoffer W. Barfod , Rikke Hoeffner , Maria Swennergren Hansen , Marianne Christensen , Henrik Riel

Background

Acute Achilles tendon rupture (ATR) is a common injury associated with a high rate of deep vein thrombosis (DVT) during rehabilitation. This study assessed whether DVT affects long-term self-reported function.

Methods

Data from the Danish Achilles Tendon Database were used to compare Achilles tendon Total Rupture Scores (ATRS) at 6, 12, and 24 months between patients with and without symptomatic DVT, adjusting for covariates.

Results

No significant ATRS difference between DVT and non-DVT groups was observed over time (adjusted mean difference = −0.7, 95 % CI: −4.8–3.3, p = 0.72). However, patients with DVT reported lower ATRS at 24 months (adjusted mean difference = −4.9, 95 % CI: −9.0 to −0.9, p = 0.02).

Conclusions

Symptomatic DVT is not significantly associated with self-reported function over time in patients with ATR. However, patients with DVT may experience a recovery plateau, leading to lower long-term function, though the clinical significance is unclear.
背景:急性跟腱断裂(ATR)是一种常见的损伤,与康复过程中深静脉血栓形成(DVT)的高发率相关。本研究评估深静脉血栓是否影响长期自我报告的功能。方法:来自丹麦跟腱数据库的数据用于比较有和无症状DVT患者在6、12和24个月的跟腱总断裂评分(ATRS),并调整协变量。结果:随着时间的推移,DVT组和非DVT组之间的ATRS无显著差异(调整后的平均差异= -0.7,95 % CI: -4.8-3.3, p = 0.72)。然而,DVT患者在24个月时报告的ATRS较低(调整后的平均差异= -4.9,95 % CI: -9.0至-0.9,p = 0.02)。结论:ATR患者的症状性DVT与自我报告的功能随时间变化无显著相关性。然而,深静脉血栓患者可能会经历一个恢复平台期,导致长期功能下降,尽管临床意义尚不清楚。
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引用次数: 0
Factors associated with improvement in ankle dorsiflexion after transfibular total ankle arthroplasty 经腓骨全踝关节置换术后踝关节背屈改善的相关因素。
IF 2 3区 医学 Q2 ORTHOPEDICS Pub Date : 2025-07-09 DOI: 10.1016/j.fas.2025.07.002
Song Ho Chang , Yuichi Nagase , Rikyo Kuhara , Taro Kasai , Jun Hirose , Shinji Mishima , Tetsuro Yasui

Background

While transfibular total ankle arthroplasty (TAA) demonstrates favorable short-term outcomes, factors influencing postoperative ankle dorsiflexion remain underexplored. This is the first study aimed to identify factors influencing dorsiflexion range of motion after transfibular TAA.

Methods

Forty-nine patients undergoing transfibular TAA were classified into dorsiflexion-improved (DF-improved) group (≥5°,n = 26) and dorsiflexion-non-improved (DF-non-improved) group (<5°, n = 23). Radiographic parameters, residual medial tibial osteophytes, and Achilles tendon lengthening were evaluated.

Results

The DF-improved group had smaller anterior talar implant depth (3.1 ± 2.0 mm vs. 5.5 ± 1.7 mm), greater γ angle (17.4 ± 4.3°vs. 14.4 ± 5.1°), smaller proportion of postoperative residual medial tibial osteophyte (2 vs. 10), and more Achilles tendon lengthening than the DF-non-improved group (9 vs. 2).

Conclusions

Close consideration of the depth and angle of talar implant placement, meticulous osteophyte resection of medial tibia, and Achilles tendon lengthening may improve the postoperative dorsiflexion following transfibular TAA.

Levels of evidence

Level III case-control study (retrospective comparative study).
背景:虽然经腓骨全踝关节置换术(TAA)显示出良好的短期效果,但影响术后踝关节背屈的因素仍未得到充分探讨。这是第一个旨在确定经腓骨TAA后影响背屈活动范围的因素的研究。方法:49例接受transfibular TAA被分为dorsiflexion-improved (DF-improved)组(≥5°n = 26)和dorsiflexion-non-improved (DF-non-improved)组(结果:DF-improved组小前talar植入深度(3.1 ±  2.0毫米和5.5 ±1.7  毫米),更大的γ角(17.4 ± 4.3°vs。14.4 ± 5.1°),术后残余胫骨内侧骨赘比例较小(2比10),跟腱延长多于df -未改善组(9比2)。结论:密切考虑距骨植入深度和角度,仔细切除胫骨内侧骨赘,延长跟腱可改善经腓骨置换术后的术后背屈。证据等级:III级病例对照研究(回顾性比较研究)。
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引用次数: 0
Efficacy of percutaneous surgery for digital deformities in older patients with comorbidities 经皮手术治疗伴有合并症的老年患者手指畸形的疗效。
IF 2 3区 医学 Q2 ORTHOPEDICS Pub Date : 2025-07-03 DOI: 10.1016/j.fas.2025.06.008
A. Herrera-Rodríguez , M. Uroz-de la Iglesia , J. Ojeda-Jiménez , D. Rendón-Díaz , E. Morales-Pérez , J.M. García-López , R. Infante-Alonso , L. Touray-Conteh , M. Herrera-Pérez

Introduction

Percutaneous forefoot surgery is a minimally invasive surgical technique with the advantages of lower morbidity and earlier recovery by allowing immediate weight bearing. These benefits represent an ideal indication for older patients with high comorbidity. This study presents the functional outcomes of this surgical technique in a series of patients with these characteristics at a tertiary-level university hospital.

Methodology

A retrospective observational study of a case series of patients who underwent this minimally invasive technique between 2022 and 2023. Epidemiological variables were collected, and the outcomes were analysed based on three parameters: resolution of ulcers, disappearance of keratoses, and the ability to wear shoes. The complete resolution of all three parameters evaluated was considered satisfactory, two resolved was acceptable, and the persistence of two or more was unsatisfactory. Given the characteristics of the series collected, only clinical follow-up was performed, with no radiological follow-up in any case.

Results

The first 30 cases operated on were collected. They had a mean age of 82.8 years and an average follow-up of 6.57 months, sufficient to evaluate medium-term postoperative results. The results were satisfactory in 83 % of cases. Half of the patients had two or more comorbidities—type 2 diabetes mellitus being the most prevalent—and the higher the number of comorbidities, the greater the risk of an unsatisfactory outcome. Surgical complications were few and mostly mild, affecting only 33 % of patients (10 cases). Those with ulcers before surgery presented the worst outcomes.

Conclusions

Percutaneous forefoot surgery for severe digital deformities in older patients with high comorbidity is an ideal minimally invasive technique with good functional outcomes and an acceptable percentage of complications.

Level of evidence

IV. Type of study: Case series.
前言:经皮前足手术是一种微创手术技术,其优点是发病率低,恢复早,可以立即负重。这些益处是高合并症老年患者的理想适应症。本研究介绍了该手术技术在三级大学医院一系列具有这些特征的患者中的功能结果。方法:对2022年至2023年间接受这种微创技术的患者进行回顾性观察研究。收集流行病学变量,并根据三个参数分析结果:溃疡消退、角化病消失和穿鞋能力。三个参数的完全解决被认为是满意的,两个解决是可以接受的,两个或更多的持久性是不满意的。考虑到收集到的病例的特点,我们只进行了临床随访,没有任何病例的放射学随访。结果:成功收集30例手术病例。平均年龄82.8岁,平均随访6.57个月,足以评估中期术后结果。83%( %)的病例结果满意。一半的患者有两种或两种以上的合并症——2型糖尿病是最普遍的——合并症的数量越多,结果不满意的风险越大。手术并发症少且大多轻微,仅影响33 %的患者(10例)。手术前有溃疡的患者表现出最差的结果。结论:经皮前足手术治疗高龄高合并症严重指畸形患者是一种理想的微创技术,具有良好的功能预后和可接受的并发症比例。证据水平:iv .研究类型:病例系列。
{"title":"Efficacy of percutaneous surgery for digital deformities in older patients with comorbidities","authors":"A. Herrera-Rodríguez ,&nbsp;M. Uroz-de la Iglesia ,&nbsp;J. Ojeda-Jiménez ,&nbsp;D. Rendón-Díaz ,&nbsp;E. Morales-Pérez ,&nbsp;J.M. García-López ,&nbsp;R. Infante-Alonso ,&nbsp;L. Touray-Conteh ,&nbsp;M. Herrera-Pérez","doi":"10.1016/j.fas.2025.06.008","DOIUrl":"10.1016/j.fas.2025.06.008","url":null,"abstract":"<div><h3>Introduction</h3><div>Percutaneous forefoot surgery is a minimally invasive surgical technique with the advantages of lower morbidity and earlier recovery by allowing immediate weight bearing. These benefits represent an ideal indication for older patients with high comorbidity. This study presents the functional outcomes of this surgical technique in a series of patients with these characteristics at a tertiary-level university hospital.</div></div><div><h3>Methodology</h3><div>A retrospective observational study of a case series of patients who underwent this minimally invasive technique between 2022 and 2023. Epidemiological variables were collected, and the outcomes were analysed based on three parameters: resolution of ulcers, disappearance of keratoses, and the ability to wear shoes. The complete resolution of all three parameters evaluated was considered satisfactory, two resolved was acceptable, and the persistence of two or more was unsatisfactory. Given the characteristics of the series collected, only clinical follow-up was performed, with no radiological follow-up in any case.</div></div><div><h3>Results</h3><div>The first 30 cases operated on were collected. They had a mean age of 82.8 years and an average follow-up of 6.57 months, sufficient to evaluate medium-term postoperative results. The results were satisfactory in 83 % of cases. Half of the patients had two or more comorbidities—type 2 diabetes mellitus being the most prevalent—and the higher the number of comorbidities, the greater the risk of an unsatisfactory outcome. Surgical complications were few and mostly mild, affecting only 33 % of patients (10 cases). Those with ulcers before surgery presented the worst outcomes.</div></div><div><h3>Conclusions</h3><div>Percutaneous forefoot surgery for severe digital deformities in older patients with high comorbidity is an ideal minimally invasive technique with good functional outcomes and an acceptable percentage of complications.</div></div><div><h3>Level of evidence</h3><div>IV. Type of study: Case series.</div></div>","PeriodicalId":48743,"journal":{"name":"Foot and Ankle Surgery","volume":"32 1","pages":"Pages 85-93"},"PeriodicalIF":2.0,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144668731","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The effect of preoperative osteoporosis on postoperative outcomes following total ankle arthroplasty 术前骨质疏松对全踝关节置换术后预后的影响。
IF 2 3区 医学 Q2 ORTHOPEDICS Pub Date : 2025-07-03 DOI: 10.1016/j.fas.2025.06.002
Grace Bennfors, Ronit Kulkarni, Joshua Morningstar, Richard J. Friedman, Christopher E. Gross, Daniel J. Scott

Introduction

Recent literature, particularly in the fields of total joint arthroplasty, has raised concern for increased perioperative complications following joint arthroplasty in patients with osteoporosis. The purpose of this study is to evaluate the influence of preoperative osteoporosis on 6-month postoperative outcomes following total ankle arthroplasty (TAA).

Methods

The Nationwide Readmissions Database (NRD) was queried from 2015 to 2020 to identify 29,705 patients undergoing primary elective TAA. Patients were divided into two cohorts based on the presence of preoperative osteoporosis, with 943 (3.2 %) having this diagnosis. Preoperative demographics, comorbidities, postoperative outcomes, cost of admission, and total length of stay (LOS) were analyzed between cohorts. Multivariate regression analyses were conducted to control for predictors of adverse postoperative outcomes other than preoperative osteoporosis.

Results

The overall cohort was majority male (54.2 %) with mean age of 64.15 (range 17–90) years, and Charlson-Deyo Comorbidity Index (CCI) score of 0.65 (range 0–12). When stratifying by preoperative osteoporosis, it was found that osteoporosis patients were statistically significantly older (Osteoporosis=68.72 years; Non-osteoporosis=65.03 years; p < .001), more likely to have Medicare insurance (p < .001), and had a higher CCI score (Osteoporosis=0.98; Non-Osteoporosis=0.64; p < .001). Multivariate regression analysis of 180-day postoperative outcomes found that preoperative osteoporosis was significantly predictive of increased risk of any complication (OR=1.428; p < .001), transfusion (OR=3.370; p < .001), pulmonary embolism (OR=5.625; p = .016), Pneumonia (OR=3.872; p < .001), non-routine discharge (OR=1.445; p < .001), and extended stay greater than 4 days (OR=1.310; p < .001). Further, preoperative presence of osteoporosis is predictive of nearly a $3000 increase in total cost of procedure (β= 2980.22; p < .001).

Conclusion

The presence of osteoporosis was significantly predictive of higher rates of postoperative complications, LOS, and a substantially higher cost of procedure following TAA. Physicians and patients alike should consider this comorbidity when stratifying risk for outcomes following total ankle arthroplasty.

Level of evidence

Level III, Retrospective Cohort Study
引言:最近的文献,特别是在全关节置换术领域,引起了对骨质疏松症患者关节置换术后围手术期并发症增加的关注。本研究的目的是评估术前骨质疏松对全踝关节置换术(TAA)术后6个月预后的影响。方法:查询2015年至2020年全国再入院数据库(NRD),确定29,705例原发性选择性TAA患者。根据术前骨质疏松的存在将患者分为两组,其中943例(3.2 %)有这种诊断。术前人口统计学、合并症、术后结果、住院费用和总住院时间(LOS)在队列之间进行分析。进行多因素回归分析以控制除术前骨质疏松症外的不良术后预后预测因素。结果:整个队列以男性为主(54.2 %),平均年龄为64.15岁(17-90岁),Charlson-Deyo共病指数(CCI)评分为0.65(0-12)。按术前骨质疏松程度分层时,骨质疏松患者年龄差异有统计学意义(骨质疏松=68.72岁;Non-osteoporosis = 65.03年;p 结论:骨质疏松症的存在显著预示着TAA术后并发症、LOS和手术费用的增加。在对全踝关节置换术后的风险进行分层时,医生和患者都应该考虑到这种合并症。证据等级:III级,回顾性队列研究。
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引用次数: 0
Mayo versus ankle block in minimally invasive hallux valgus surgery: A comparative study 微创拇外翻手术中梅奥与踝关节阻滞的比较研究。
IF 2 3区 医学 Q2 ORTHOPEDICS Pub Date : 2025-07-01 DOI: 10.1016/j.fas.2025.06.007
Gabriel Ferraz Ferreira , Caio Rafael Ebram de Miranda , Marcos Vinícius de Paula Matarézio , Davy Sevilla , Vitor Alves Patriarcha , Thomas Lorchan Lewis , Robbie Ray , Gustavo Araujo Nunes , Miguel Viana Pereira Filho

Background

Postoperative pain in foot surgeries can be significant, making regional anesthesia the preferred approach. Regional anesthesia enhances pain control, reduces sedative and opioid needs, shortens hospital stays, and improves patient satisfaction. The aim of this study is to compare the Ankle Block (AB) and the Mayo Block (MB) as a measure of postoperative analgesia for hallux valgus (HV) surgery.

Methods

This retrospective comparative study included patients with HV who underwent correction between November 2023 and July 2024. Patients received either an AB or MB with ropivacaine (7.5 mg/mL) for postoperative pain. The primary outcome was pain assessment at 12 and 24 h postoperatively using the Visual Analog Scale (VAS). Secondary outcomes were analgesic and opioid use, anesthesia duration in hours, and patient comfort on the first postoperative night. Statistical analysis was performed with a 5 % significance level, using R software.

Results

A total of 39 patients (57 feet) were included, with 20 receiving AB and 19 receiving MB. No statistically significant differences in primary outcome VAS scores were observed between groups at 12 or 24 h (p > 0.05). Analgesic and opioid use, as well as comfort on the first postoperative night, were similar between groups.

Conclusion

The Ankle Block and Mayo Block each proved effective in controlling postoperative pain following HV surgery. We recommend the use of the Mayo Block for percutaneous hallux valgus correction surgery, as it requires a smaller anesthetic volume, preserves plantar sensation, and may thus facilitate earlier mobilization and reduce the risk of falls.

Level of Evidence

Level III, retrospective comparative study.
背景:足部手术术后疼痛可能很严重,因此区域麻醉是首选的方法。区域麻醉增强疼痛控制,减少镇静剂和阿片类药物需求,缩短住院时间,提高患者满意度。本研究的目的是比较踝关节阻滞(AB)和梅奥阻滞(MB)作为拇外翻(HV)手术术后镇痛的测量方法。方法:这项回顾性比较研究纳入了2023年11月至2024年7月期间接受矫治的HV患者。患者接受AB或MB联合罗哌卡因(7.5 mg/mL)治疗术后疼痛。主要结局是术后12和24 h使用视觉模拟评分(VAS)评估疼痛。次要结果是镇痛药和阿片类药物的使用,麻醉时间(小时)和术后第一个晚上患者的舒适度。采用R软件进行统计学分析,显著性水平为5 %。结果:共纳入39例患者(57英尺),其中AB组20例,MB组19例。12、24小时 h组间主要结局VAS评分差异无统计学意义(p > 0.05)。镇痛药和阿片类药物的使用,以及术后第一个晚上的舒适度,两组之间相似。结论:踝关节阻滞和梅奥阻滞均可有效控制HV术后疼痛。我们推荐使用Mayo Block进行经皮拇外翻矫正手术,因为它需要较小的麻醉量,保留足底感觉,因此可以促进早期活动并减少跌倒的风险。证据等级:III级,回顾性比较研究。
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引用次数: 0
期刊
Foot and Ankle Surgery
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