Risk Factors Associated With Nonunion After Elective Foot and Ankle Reconstruction: A Case-Control Study
| Autor: | Alan R. Catanzariti, Kyle R. Moore, Karl Saltrick, Michael A. Howell |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
Adult
Male medicine.medical_specialty Arthrodesis medicine.medical_treatment Nonunion 030209 endocrinology & metabolism Endocrine System Diseases vitamin D deficiency 03 medical and health sciences 0302 clinical medicine Postoperative Complications Risk Factors Foot Joints Medicine Humans Orthopedics and Sports Medicine Treatment Failure Parathyroid disease Aged Aged 80 and over 030222 orthopedics Endocrine disease business.industry Case-control study Middle Aged medicine.disease Vitamin D Deficiency Surgery Radiography medicine.anatomical_structure Case-Control Studies Female Ankle business Body mass index Ankle Joint |
| Zdroj: | The Journal of foot and ankle surgery : official publication of the American College of Foot and Ankle Surgeons. 56(3) |
| ISSN: | 1542-2224 |
| Popis: | Postoperative nonunion is not uncommon in the lower extremity, and significant morbidity can be associated with nonunion of the foot and ankle after surgical reconstruction. For the purposes of the present study, we retrospectively reviewed and compared a cohort of patients who had undergone elective foot and ankle reconstruction to better assess the modifiable risk factors associated with postoperative nonunion. We hypothesized that the presence of endocrine and metabolic abnormalities are often associated with nonunion after foot and ankle surgical reconstruction. We formulated a matched case-control study that included 29 patients with nonunion and a control group of 29 patients with successful fusion to assess the prevalence of certain modifiable risk factors known to have an association with nonunion after foot and ankle arthrodesis. The modifiable risk factors assessed included body mass index, tobacco use, diabetes mellitus, vitamin D abnormality, thyroid dysfunction, and parathyroid disease. A statistically significant (p < .05) difference was found between the 2 groups for endocrine and metabolic disease diagnoses in the medical records of the 58 patients identified. Thus, 76% versus 26% (p < .05) of patients experienced nonunion in the endocrine disease group versus the nonendocrine disease group, respectively. Patients with vitamin D deficiency or insufficiency were 8.1 times more likely to experience nonunion (95% confidence interval 1.996 to 32.787). No statistically significant differences were found between the groups in terms of age, sex, tobacco use, body mass index, or procedure selection (p = .56, p = .43, p = .81, p = .28, and p = 1.0, respectively). A greater prevalence of endocrine abnormalities, in particular, vitamin D deficiency and insufficiency, was associated with nonunion after elective foot and ankle reconstruction. Patients with such abnormalities appear to have a greater risk of developing nonunion after arthrodesis procedures. |
| Databáze: | OpenAIRE |
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