背景:髌骨结合是儿童足部疼痛的重要原因。早期估计患病率高达2%,而最近的数据表明,这一比例高达11%至13%。据我们所知,目前还没有基于人群的研究来确定儿科人群中症状性髌骨结合的真实发生率.
方法:使用基于人群的数据库来确定1966年至2018年之间18岁或18岁以下儿童的所有新诊断症状性tal骨联盟。患者记录被审查的临床数据,并在确定的联盟的类型和特征之间进行了比较,以确定受影响人群的差异。年度特定年龄,性别特异性,和类型特异性发病率进行了估计。
结果:在研究期间,共确定了58例患者,共有79个症状性tal骨联盟(年发病率=每100,000名儿童3.5)。有43个跟骨(CN)联盟(年发病率=每100,000名儿童1.9),27个talocalcaneal(TC)联盟(年发病率=每100,000名儿童1.2),以及其他9个联盟(7个距骨,1naviculocuboid,和1个蛇形物)(年发病率=每100,000名儿童0.4)。男孩和女孩的总体发病率在10至14岁之间达到顶峰(8.1/100,000和7.4/100,000儿童,分别)。在tal骨联盟的类型之间确定了统计差异。相对于CN和其他联盟,TC联盟年龄较大(平均,13.9、12.7和11.4年,分别为;p=0.02)。虽然CN和TC联盟的组成相似(23%和30%,分别,是骨的,而不是纤维软骨的),其他联盟更可能是骨(78%)(p=0.0035)。与CN和TC联盟相比,其他联盟也不太可能需要手术(11%,74%,56%,分别为;p=0.0015)。
结论:这项以人群为基础的研究表明,在tal骨联盟的临床表现上存在差异,并对儿童人群中症状性tal骨联盟的真实发生率进行了估计。
BACKGROUND: Tarsal coalitions are an important reason for foot pain in children. Early estimates placed the prevalence at up to 2%, while more recent data suggest that it is as high as 11% to 13%. To our knowledge, there have been no population-based studies to determine the true incidence of symptomatic tarsal coalitions in a pediatric population.
METHODS: A population-based database was used to identify all new diagnoses of symptomatic tarsal coalitions in children 18 years old or younger between 1966 and 2018. Patient records were reviewed for clinical data, and comparisons were made between the types and characteristics of the coalitions identified to determine differences in the affected populations. The annual age-specific, sex-specific, and type-specific incidence rates were estimated.
RESULTS: During the
study period, 58 patients with a total of 79 symptomatic tarsal coalitions were identified (annual incidence = 3.5 per 100,000 children). There were 43 calcaneonavicular (CN) coalitions (annual incidence = 1.9 per 100,000 children), 27 talocalcaneal (TC) coalitions (annual incidence = 1.2 per 100,000 children), as well as 9 other coalitions (7 talonavicular, 1 naviculocuboid, and 1 naviculocuneiform) (annual incidence = 0.4 per 100,000 children). The overall incidence peaked between the ages of 10 and 14 years for both boys and girls (8.1 per 100,000 and 7.4 per 100,000 children, respectively). Statistical differences were identified between the types of tarsal coalitions. TC coalitions present at an older age relative to CN and other coalitions (mean,13.9, 12.7, and 11.4 years, respectively; p = 0.02). While CN and TC coalitions were similar in composition (23% and 30%, respectively, were osseous as opposed to fibrocartilaginous), other coalitions were more likely to be osseous (78%) (p = 0.0035). Other coalitions were also less likely to require surgery than CN and TC coalitions (11%, 74%, and 56%, respectively; p = 0.0015).
CONCLUSIONS: This population-based
study demonstrates differences in the clinical presentation of tarsal coalitions and provides an estimate of the true incidence of symptomatic tarsal coalitions in a pediatric population.