Safety of malleolar osteotomies in surgery for osteochondral lesions of the talus

Autor: Ronny Lopes, Victor Dubois-Ferrière, Thomas Amouyel, Olivier Barbier, Nicolas Baudrier, Antoine Morvan, Carlos Maynou, Frédéric Leiber, Giovany Padiolleau, Jonathan Benoist, Didier Mainard, Nicolas de l’Escalopier, Guillaume Cordier
Přispěvatelé: Centre hospitalier universitaire de Nantes (CHU Nantes), Département universitaire de chirurgie orthopédique et de traumatologie, hôpital Salengro, CHRU de Lille, Centro de Investigacion y de Estudios Avanzados del Instituto Politécnico Nacional (CINVESTAV), Service de chirurgie orthopédique et traumatologique, hôpital d'Instruction des Armées Percy, 92140 Clamart, France, parent, Centre de chirurgie orthopédique et sportive, 2, rue Negrevergne, 33700 Mérignac, France, Hôpital Ambroise Paré [AP-HP], Laboratoire d'Informatique, de Traitement de l'Information et des Systèmes (LITIS), Institut national des sciences appliquées Rouen Normandie (INSA Rouen Normandie), Institut National des Sciences Appliquées (INSA)-Normandie Université (NU)-Institut National des Sciences Appliquées (INSA)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Université Le Havre Normandie (ULH), Normandie Université (NU), Division of Paediatrics Orthopaedic [Geneva], Geneva University Hospital (HUG), Cabinet de Cardiologie Foetale Pediatrique et Congenitale Adulte et Groupement d'Exploration Radiologique et Cardiovasculaire, Clinique de l'Orangerie, 67000 Strasbourg, Institut de Recherche Dupuy de Lôme (IRDL), Université de Bretagne Sud (UBS)-Université de Brest (UBO)-École Nationale Supérieure de Techniques Avancées Bretagne (ENSTA Bretagne)-Centre National de la Recherche Scientifique (CNRS), Ingénierie Moléculaire et Physiopathologie Articulaire (IMoPA), Université de Lorraine (UL)-Centre National de la Recherche Scientifique (CNRS), Service de Chirurgie Orthopédique, Traumatologique et Arthroscopique [CHRU Nancy] (COTA), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)
Rok vydání: 2021
Předmět:
Zdroj: Orthopaedics and Traumatology-Surgery and Research
Orthopaedics and Traumatology-Surgery and Research, Elsevier, 2021, pp.103070. ⟨10.1016/j.otsr.2021.103070⟩
ISSN: 1877-0568
Popis: The talus is a central bone in the hindfoot that is difficult to access surgically. Performing a medial or lateral malleolar osteotomy in the management of an osteochondral lesion of the talus (OLT) is a feared procedure amongst surgeons and their patients. The objective of this study was to assess the complications inherent to malleolar osteotomies in the treatment of OLTs. Hypothesis: The use of a standardized protocol concerning the technical performance and osteosynthesis of malleolar osteotomies results in fewer postoperative complications than a non-standardized protocol. Materials and method: This is a comparative study comprising a prospective multicenter non-randomized series with a standardized protocol for performing malleolar osteotomies, and a multicenter retrospective series without a standardized protocol. We included all patients aged 16 to 65 years with symptomatic OLTs, resistant to more than 6-months of well-conducted medical treatment, for whom surgery was considered. The minimum follow-up was 1 year for the prospective study, and 5 years for the retrospective study. A total of 86 and 97 patients were included in the prospective and retrospective studies, respectively. Of these 183 patients, 86 patients (33 prospective and 53 retrospective) underwent medial or lateral malleolar osteotomies as part of their surgery for OLT. Complications specific to the osteotomy procedures such as scar tissue, surgical site infection, non-union, articular malunion, neurological lesions or surgical revision, were investigated. Results: No specific complication was found to be associated to the malleolar osteotomy. No surgical revision was directly linked to the osteotomy procedure. No significant difference was found between the two series. Discussion: There was no evidence of morbidity related specifically to medial or lateral malleolar osteotomies. A standardized protocol, subject to rigorous technical implementation, does not improve results after malleolar osteotomy. The fear associated with this malleolar osteotomy procedure seems unfounded. Level of evidence: IV
Databáze: OpenAIRE
Externí odkaz: