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題 名 | Equinovarus Deformity Prevention by Tibiotalocalcaneal Fusion or Tendon Transfer Procedure following Chopart Amputation |
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作 者 | Liang, Chun-ming; Chiu, Yen-chun; Wu, Chin-hsien; Tsai, Kun-ling; Tu, Yuan-kun; Ma, Ching-hou; | 書刊名 | Formosan Journal of Musculoskeletal Disorders |
卷 期 | 14:1 2023.01-03[民112.01-03] |
頁 次 | 頁25-30 |
分類號 | 416.619 |
關鍵詞 | Chopart amputation; Foot crush injury; Tendon transfer; Tibiotalocalcaneal arthrodesis; |
語 文 | 英文(English) |
DOI | 10.4103/FJMD.FJMD_308 |
英文摘要 | Background: Management of severe foot injuries usually requires varying levels of amputation. Chopart amputation has several advantages over hindfoot amputation. However, a painful equinovarus deformity is a major complication that may be prevented using the tendon transfer (TT) procedure or tibiotalocalcaneal (TTC) fusion. Objectives: This study aimed to compare the results of utilizing the procedures in preventing postoperative equinovarus deformities. Materials and Methods: Seventeen patients with severe foot injuries who required Chopart amputation were enrolled in our study. Inclusion criteria were severe damage and necrosis of soft tissue without damage to the talus, calcaneus, and plantar heel skin. Eight patients were treated using the TT procedure (group) and nine by TTC fusion (group). Results: Five patients of the TT group experienced different severities of equinovarus deformities. The median American Orthopaedic Foot and Ankle Society (AOFAS) Ankle‑Hindfoot Scale scores of 60 (range, 52–68) for the TT group and 78 (range, 72–80) for the TTC group were observed. Moreover, the median 36‑item short‑form (SF‑36) score was 68 (range, 64–72) for the TT group and 83 (range, 78–86) for the TTC group. Statistical analysis showed that the AOFAS and SF‑36 scores improved significantly for the TTC group compared with those for the TT group. Conclusions: Improved functional outcomes were observed for the TTC group. However, a cautious selection of patients, meticulous soft‑tissue management, the inclusion of a free flap reconstruction technique, and adequate TTC fusion are required for the treatment of severe foot crush injuries. |
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