Abstract：
Common corrective osteotomies used in flexible flatfoot deformity reconstruction include Cotton and Evans osteotomies, which require structural graft to maintain correction. Auto-, allo-, and xenografts are associated with a number of limitations, including disease transmission, rejection, donor site morbidity, technical challenges related to graft fashioning, and graft resorption. Porous titanium is a synthetic substance designed to address these flaws; however, few studies have been reported on the efficacy, safety, and long-term outcomes. A multicenter retrospective cohort of 63 consecutive preconfigured porous titanium wedges (PTWs) used in flexible flatfoot reconstructions from June 1, 2009 to June 30, 2015 was evaluated. The primary outcome measure was the pre- to postdeformity correction efficacy. The secondary outcomes included maintenance of correction at a minimum follow-up point of 12 months, complications, graft incorporation, and graft safety profile. Multivariate linear regression found a statistically significant improvement in all radiographic parameters from preoperatively to the final weightbearing radiographs (calcaneocuboid 18.850 ± 4.020 SE, p < .0001; Kite\'s, 7.810 ± 3.660 SE, p = .04; Meary\'s 13.910 ± 3.100 SE, p = .0001; calcaneal inclination, 5.550 ± 2.140 SE, p = .015). When restricted to patients with >4 years of follow-up data, maintenance of correction appeared robust in all 4 measurements, demonstrating a lack of bone or graft resorption. No patients were lost to follow-up, no major complications or implant explantation or migration occurred, and all implants were incorporated. Minor complications included hardware pain from plates over grafts (8%), 1 case of scar neuritis, and a 5% table incidence of transfer pain associated with the PTWs. These results support the use of PTWs for safety and degree and maintenance of correction in flatfoot reconstruction.
摘要：
用于柔性扁平足畸形重建的常见矫正截骨术包括Cotton和Evans截骨术，这需要结构性移植来维持矫正。自动-,allow-,异种移植与许多限制有关，包括疾病传播,拒绝,供体部位发病率，与嫁接成型相关的技术挑战，和移植物吸收。多孔钛是一种旨在解决这些缺陷的合成物质；然而，很少有关于疗效的研究报道，安全,和长期结果。评估了2009年6月1日至2015年6月30日在柔性平足重建中使用的63个连续预先配置的多孔钛楔块（PTW）的多中心回顾性队列。主要结局指标是畸形矫正前后的疗效。次要结果包括在至少12个月的随访点维持矫正，并发症,接枝掺入，和移植物安全概况。多元线性回归发现，从术前到最终的负重X线片，所有X线参数均有统计学上的显着改善（跟骨眼18.850±4.020SE，p<.0001;风筝,7.810±3.660SE，p=.04；Meary的13.910±3.100SE，p=.0001；跟骨倾斜度，5.550±2.140SE，p=.015）。如果仅限于随访数据>4年的患者，在所有4次测量中，校正的维持都显得稳健，显示缺乏骨或移植物吸收。没有病人失去随访，无重大并发症或植入物移植或迁移发生，和所有的植入物被纳入。轻微的并发症包括从移植板硬件疼痛（8％），1例瘢痕神经炎,与PTW相关的转移疼痛发生率为5%。这些结果支持在平足重建中使用PTW进行安全性和程度以及维持矫正。
