Journal of Korean Foot and Ankle Society (대한족부족관절학회지)
- Volume 15 Issue 4
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- Pages.201-206
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- 2011
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- 1738-3757(pISSN)
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- 2288-8551(eISSN)
Subtalar Distraction Arthrodesis Using Frozen Allobone Graft by Interpositional Structural
동결 동종골의 구조적 삽입을 이용한 거골하 신연 유합술
- Choi, Jang-Seok (Department of Orthopedic Surgery, Gil Hospital, Gacheon University of Medicine and Science) ;
- Kwak, Ji-Hoon (Department of Orthopedic Surgery, Gil Hospital, Gacheon University of Medicine and Science) ;
- Jun, Sung-Soo (Department of Orthopedic Surgery, Gil Hospital, Gacheon University of Medicine and Science) ;
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Park, Hong-Gi
(Department of Orthopedic Surgery, Gil Hospital, Gacheon University of Medicine and Science)
- 최장석 (가천의과학대학교 길병원 정형외과) ;
- 곽지훈 (가천의과학대학교 길병원 정형외과) ;
- 전성수 (가천의과학대학교 길병원 정형외과) ;
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박홍기
(가천의과학대학교 길병원 정형외과)
- Received : 2011.10.11
- Accepted : 2011.11.15
- Published : 2011.12.15
Abstract
Purpose: Subtalar distraction arthrodesis is useful treatment option for restore hindfoot alignment. but, using structural autograft have high risk of donor site morbidity. Recently, by replacing the structural allograft has been reported satisfactory clinical results. Therefore, the authors reviewed the results of subtalar distraction arthrodesis using a structural allograft, retrospectively. Materials and Methods: From January 2008 to May 2010, 12 patients (12 feets; 9 male, 3 female) underwent subtalar distraction arthrodesis using frozen structural allograft. 9 cases were calcaneal malunion, 2 were nonunion or malunion after subtalar arthrodesis, 1 was other cause. Mean age was 38.9 (12~66) years old and follow up period was 16.5 (12~36) months. Surgical was performed with posterolateral approach and tricortical allobone block of frozen femoral neck was used. Analysis was done with retorspective manner to evaluate preoperative, postoperative, and final follow up radiologic measurement and AOFAS ankle-hindfoot scale. Results: There was statistically significant increase (p<0.05) of ankle-hindfoot scale from preoperative 27.5 points to postoperative 72.5 points, talocalcaneal height by 6.62 mm, calcaneal pitch angle by 5.73 degrees, lateral talocalcaneal angle by 6.38 degrees and significant decrease (p<0.05) of tali-1st metatarsal angle by 5.23 degrees. 11 feet (91.7%) acquired bony union and it takes average 5.1 months. Final post-operative result revealed talocalcaneal height changed by 2.57 mm, calcaneal pitch anble, lateral talocalcaneal angle, talar-1st metatarsal angle were changed by 2.63 degrees, 1.62 degrees, 1.18 degrees, respectively (p<0.05). 3 cases of partial osteonecrosis of posterior facet of calcaneus were observed in operation field, 4 cases of complication were developed (1 case of nonunion, 1 collapse of allobone graft, 1 screw loosening, 1 superficial skin necrosis). Conclusion: Subtalar distraction arthrodesis using frozen structural allobone graft is useful alternative treatment method of arthrodesis with structural autobone graft.