在有症状的患者中,最常见的tal骨联盟类型是跟骨联盟。非手术治疗对大多数患者有效。然而,如果需要手术,切除跟骨关节可以是保留后脚活动和功能的成功选择。我们根据系统评价和荟萃分析方案(PRISMA-P)清单的首选报告项目对跟骨动脉切除术进行了系统评价。进行审查,我们对几个数据库进行了彻底的搜索,包括PubMed,科克伦,摘录医学数据库(EMBASE),护理和相关健康文献累积指数(CINAHL),谷歌学者,和参考书目。我们分析了选定的研究,以收集有关患者人口统计的信息,临床结果,外科技术,和潜在的并发症。我们确定了11项研究,其中包括274名患者,共394英尺。这些研究中患者的平均年龄为12.5岁,8.2至19.4年不等。后续期从2.3年到23年不等,平均期限为5.9年。跟骨切除在380英尺处进行,而融合是在14英尺处进行的。在50.5%的脚中,趾短伸肌被用作插入材料。在82.9%的病例(304英尺)中观察到酒吧切除术后的成功结果,并被描述为令人满意,改进,不错,或出色的结果。在一项研究中,美国骨科足踝协会(AOFAS)评分在12英尺的酒吧切除术后从47.89提高到90.22.据报道,在接受酒吧切除术的380英尺中,有52英尺出现了复发。据报道,25英尺的踝关节和距下关节关节炎进展。报告了各种并发症,包括后脚(三英尺)的感觉异常,中足疼痛(三英尺),后脚疼痛(两只脚),轻度伤口感染(一只脚),肿胀和僵硬(一只脚)。手术切除的跟骨关节在大多数患者中显示出成功的结果。无论是否使用插入式材料。这些结果与最小和可接受的并发症相关。然而,由于文献中进行的研究是单中心回顾性和前瞻性试验,一项以患者为中心的多中心前瞻性研究,验证的结果将提供一个更好的机会来支持支持手术切除跟骨动脉的证据。总的来说,与未使用介入材料的病例相比,使用各种介入材料可降低复发几率.
The most commonly encountered type of tarsal coalition in symptomatic patients is the calcaneonavicular coalition. Non-surgical treatments are effective for most patients. However, if surgery is required, excision of the calcaneonavicular bar can be a successful option that preserves hindfoot mobility and function. We conducted a systematic review of calcaneonavicular bar excision in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) checklist. To conduct the review, we conducted a thorough search of several databases, including PubMed, Cochrane, Excerpta Medica Database (EMBASE), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Google Scholar, and bibliographies. We analyzed the chosen studies to collect information on patient demographics, clinical outcomes, surgical techniques, and potential complications. We identified 11 studies that included 274 patients for a total of 394 feet. The average age of patients in these studies was 12.5 years, ranging from 8.2 to 19.4 years. Follow-up periods varied from 2.3 to 23 years, with an average duration of 5.9 years. Excision of the calcaneonavicular bar was performed at 380 feet, while fusion was performed at 14 feet. In 50.5% of the feet, the extensor digitorum brevis was used as an interposition material. Successful outcomes after bar excision were observed in 82.9% of cases (304 feet) and were described as satisfactory, improved, good, or excellent outcomes. In one study, the American Orthopaedic Foot and Ankle Society (AOFAS) score improved from 47.89 to 90.22 in 12 feet after bar excision. Recurrence was reported in 52 feet out of the 380 feet that underwent bar excision. Progression of arthritis in the ankle and subtalar joint was reported in 25 feet. Various complications were reported, including paraesthesia in the hindfoot (three feet), midfoot pain (three feet), hindfoot pain (two feet), mild wound infection (one foot), and swelling and stiffness (one foot). Surgical excision of the calcaneonavicular bar has shown successful outcomes in most patients, regardless of the use of interposition material. These outcomes are associated with minimal and acceptable complications. However, since the studies conducted in the literature were single-center retrospective and prospective trials, a multicenter prospective study with patient-centered, validated outcomes would provide a better opportunity to support the evidence in favor of surgical excision of the calcaneonavicular bar. Overall, the use of various interposition materials is associated with reduced chances of recurrence compared to cases where no interposition material was used.