■移除联合椎板螺钉的指示尚未完全阐明。本研究旨在确定与选择性联合椎管螺钉移除相关的因素。
■接受踝关节联合损伤固定术的患者。在疼痛手术后至少12周后提供螺钉移除,僵硬或患者希望移除疼痛或破损的硬件。患者人口统计学,手术数据,滑膜联合螺钉与关节的距离,螺钉在physeal疤痕处的位置,收集所有患者的联合椎板螺钉数量。进行了双变量和多变量分析,以确定患者特征与螺钉移除之间的关系以及硬件移除的独立预测因素。
■160名患者中,60例患者(38%),平均年龄为36.1(范围:18-84)岁,平均7(范围,初次固定后3-47)个月。移除螺钉的最常见原因(50/60患者)是踝关节僵硬和疼痛(83%)。双变量分析显示,接受螺钉拔除的患者年龄更年轻(36.1岁±13.0vs46.6岁±18.2,P<.001),ASA评分较低(2±0.8vs2.1±0.7,P=.003)。在接受螺钉移除的患者中,21.7%(13/60)在移除时螺钉断裂。是否将螺钉放置在植骨疤痕处与患者决定移除硬件没有显着相关(P=.80)。
年轻和健康的患者更有可能接受选择性切除联合椎管硬件。螺钉与关节的距离以及螺钉在physeal疤痕处的放置与硬件移除没有显着相关。
■三级,回顾性队列研究。
UNASSIGNED: Indications for removal of syndesmotic screws are not fully elucidated. This study aimed to determine factors related to elective syndesmotic screw removal.
UNASSIGNED: Patients who underwent fixation of ankle syndesmotic injuries were included. Screw removal was offered after a minimum of 12 weeks after surgery for pain, stiffness or patient desire to remove painful or broken hardware. Patient demographics, surgical data, distance of the syndesmotic screw from the joint, location of the screw at the physeal scar, and number of syndesmotic screws placed were collected for all patients. Bivariate and multivariate analyses were performed to determine the relationship between patient characteristics and screw removal and independent predictors of hardware removal.
UNASSIGNED: Of 160 patients, 60 patients (38%) with an average age of 36.1 (range: 18-84) years underwent elective syndesmotic screw removal at a mean of 7 (range, 3-47) months after initial fixation. The most common reason for screw removal (50/60 patients) was ankle stiffness and pain (83%). Patients who underwent screw removal were more likely to be younger (36.1 years ± 13.0 vs 46.6 years ± 18.2, P < .001) and have a lower ASA score (2 ± 0.8 vs 2.1 ± 0.7, P = .003) by bivariate analysis. Of patients who underwent screw removal, 21.7% (13/60) had a broken screw at the time of removal. Whether the screw was placed at the physeal scar was not significantly associated with patient decision for hardware removal (P = .80).
UNASSIGNED: Younger and healthier patients were more likely to undergo elective removal of syndesmotic hardware. Screw distance from joint and screw placement at the physeal scar were not significantly associated with hardware removal.
UNASSIGNED: Level III, retrospective cohort study.