Abstract：
BACKGROUND: Minimally invasive surgery (MIS) in medial displacement calcaneus osteotomy (MDCO) has been proposed for surgical correction of adult-acquired flat foot deformity (AAFD) to reduce complications of open approaches. The aim of our study is to systematically analyze complications and the clinical and radiological results of MIS- MDCO.
METHODS: A systematic review of the English literature was performed on 30th October 2023. Randomized controlled trials and non-randomized trials, cohort studies, case-control studies and case series concerning surgical correction of AAFD with MIS-MDCO and with at least 15 patients were included. Case reports, technical notes, animal or cadaveric studies were excluded. The quality and risk of bias of the studies included were evaluated using GRADE and MINORS systems. Complications rate, clinical and radiological results were inferred from the studies included.
RESULTS: Nine articles were included. A total of 501 cases treated with MIS-MDCO were analysed with a mean follow-up of 11.9 ± 5.1 months. The reported wound infection rate was about 3% and sural neuropathy was rated about 1%. Only 4% of the cases required removal of the screw for pain. In the comparative studies (MIS versus Open MDCO), comparable clinical results but with significant differences (P < 0.001) in infection rates (1% versus 14%) and sural neuropathy (2% versus 1%) were observed.
CONCLUSIONS: AAFD correction performed with MIS-MDCO, with the limitation of a poor quality and high risk of bias of the included studies, seems to provide good clinical results and high subjective satisfaction with a lower complication rate compared to open approach. Further high-quality long-term comparative studies could better clarify complications and clinical and radiological outcomes of the MIS technique in the treatment of AAFD.
METHODS: Level IV.
METHODS: A systematic review of the English literature was performed on 30th October 2023. Randomized controlled trials and non-randomized trials, cohort studies, case-control studies and case series concerning surgical correction of AAFD with MIS-MDCO and with at least 15 patients were included. Case reports, technical notes, animal or cadaveric studies were excluded. The quality and risk of bias of the studies included were evaluated using GRADE and MINORS systems. Complications rate, clinical and radiological results were inferred from the studies included.
RESULTS: Nine articles were included. A total of 501 cases treated with MIS-MDCO were analysed with a mean follow-up of 11.9 ± 5.1 months. The reported wound infection rate was about 3% and sural neuropathy was rated about 1%. Only 4% of the cases required removal of the screw for pain. In the comparative studies (MIS versus Open MDCO), comparable clinical results but with significant differences (P < 0.001) in infection rates (1% versus 14%) and sural neuropathy (2% versus 1%) were observed.
CONCLUSIONS: AAFD correction performed with MIS-MDCO, with the limitation of a poor quality and high risk of bias of the included studies, seems to provide good clinical results and high subjective satisfaction with a lower complication rate compared to open approach. Further high-quality long-term comparative studies could better clarify complications and clinical and radiological outcomes of the MIS technique in the treatment of AAFD.
METHODS: Level IV.
摘要：
背景：已经提出了内侧移位跟骨截骨术（MDCO）的微创手术（MIS）用于手术矫正成人获得性扁平足畸形（AAFD），以减少开放入路的并发症。我们研究的目的是系统分析MIS-MDCO的并发症以及临床和放射学结果。
方法：于2023年10月30日对英文文献进行了系统回顾。随机对照试验和非随机试验，队列研究，纳入病例对照研究和病例系列,这些研究涉及使用MIS-MDCO和至少15例患者的AAFD手术矫正.病例报告,技术说明,动物或尸体研究被排除在外.使用GRADE和MINORS系统评估纳入研究的质量和偏倚风险。并发症发生率,从纳入的研究推断临床和放射学结果.
结果：纳入了9篇文章。共分析了501例接受MIS-MDCO治疗的病例，平均随访时间为11.9±5.1个月。报告的伤口感染率约为3％，腓肠神经病约为1％。只有4％的病例需要拔除螺钉以进行疼痛。在比较研究(MIS与开放式MDCO)中，观察到具有可比性的临床结果,但在感染率(1%对14%)和腓肠神经病变(2%对1%)方面存在显著差异(P<0.001).
结论：使用MIS-MDCO进行AAFD校正，由于纳入研究质量差、偏倚风险高的局限性，与开放方法相比，似乎提供了良好的临床结果和较高的主观满意度，并发症发生率较低。进一步的高质量长期比较研究可以更好地阐明MIS技术治疗AAFD的并发症以及临床和放射学结果。
方法：四级。
方法：于2023年10月30日对英文文献进行了系统回顾。随机对照试验和非随机试验，队列研究，纳入病例对照研究和病例系列,这些研究涉及使用MIS-MDCO和至少15例患者的AAFD手术矫正.病例报告,技术说明,动物或尸体研究被排除在外.使用GRADE和MINORS系统评估纳入研究的质量和偏倚风险。并发症发生率,从纳入的研究推断临床和放射学结果.
结果：纳入了9篇文章。共分析了501例接受MIS-MDCO治疗的病例，平均随访时间为11.9±5.1个月。报告的伤口感染率约为3％，腓肠神经病约为1％。只有4％的病例需要拔除螺钉以进行疼痛。在比较研究(MIS与开放式MDCO)中，观察到具有可比性的临床结果,但在感染率(1%对14%)和腓肠神经病变(2%对1%)方面存在显著差异(P<0.001).
结论：使用MIS-MDCO进行AAFD校正，由于纳入研究质量差、偏倚风险高的局限性，与开放方法相比，似乎提供了良好的临床结果和较高的主观满意度，并发症发生率较低。进一步的高质量长期比较研究可以更好地阐明MIS技术治疗AAFD的并发症以及临床和放射学结果。
方法：四级。
