Does the stabilization of the calcaneocuboid joint with Steinmann pin in Evans osteotomy affect its incidence of arthritis?
| Autor: | Jaclyn F. Hill, Isaiah G. Roepe, Brett Heldt, Elsayed Attia, Vinitha R. Shenava |
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| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Calcaneocuboid joint Adolescent Radiography medicine.medical_treatment Arthritis Osteotomy medicine Humans Orthopedics and Sports Medicine Podiatry Child Retrospective Studies Subluxation business.industry Incidence Odds ratio medicine.disease Flatfoot Confidence interval Surgery Calcaneus medicine.anatomical_structure business Body mass index |
| Zdroj: | Foot (Edinburgh, Scotland). 49 |
| ISSN: | 1532-2963 |
| Popis: | Purpose This study aims to determine the effect of retaining a Steinmann pin in the calcaneocuboid joint on its rates of arthritis following Evans calcaneal osteotomy lengthening procedure. The study hypothesized that leaving the pin across the calcaneocuboid joint post-operatively would lead to higher rates of arthritis. Methods This is a retrospective review of patients under 18 years of age who underwent Evans osteotomy at our hospital from January 2015 to May 2020. The Patients were stratified into 2 groups: Group 1 (pin was left post-operatively across the joint and removed on follow-up) and Group 2 (pin was removed during surgery). Demographic data were recorded, including age, sex, and body mass index. Calcaneocuboid arthritis was determined by radiographic imaging at least one-year follow-up. Time to pin removal, size of the pin and graft, and subluxation were analyzed as possible risk factors for arthritis. Odds ratios (OR) and corresponding 95% confidence intervals (CI) were estimated. Results 39 patients were included in the study: 24 patients had the pin removed post-operatively, and 15 had the pin removed intra-operatively. There were no significant differences between the 2 groups regarding body mass index, age, sex, or laterality. Calcaneocuboid arthritis rates were significantly higher in the Group 1 than Group 2 (12(50%) vs. 2(13.3%), respectively; p = 0.02). On multivariate regression, both age (OR, 1.305 [95%CI: 1.009−1.696]; p = 0.044) and leaving the pin in the joint postoperatively (OR, 7.661 [95%CI: 1.208−48.570]; p = 0.031) were found as risk factors for arthritis at follow-up. The mean time to pin removal, the size of the pin, and the size of the graft were not found to be significant predictors of arthritis (p > 0.05). Conclusions This study shows that leaving the Steinmann pin in the calcaneocuboid joint in children post-operatively is associated with an increased risk of developing early radiographic signs of calcaneocuboid joint arthritis. |
| Databáze: | OpenAIRE |
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