Smoking and obesity influence the risk of nonunion in lateral opening wedge, closing wedge and torsional distal femoral osteotomies
Smoking and obesity influence the risk of nonunion in lateral opening wedge, closing wedge and torsional distal femoral osteotomies
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DOI：
10.1007/s00167-017-4754-9
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发表时间：
2018-09-01
影响因子：
3.8
通讯作者：
Imhoff, Andreas B.
中科院分区：
文献类型：
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作者：
Liska, Franz;Haller, Bernhard;Imhoff, Andreas B.
目的侧端远端截骨术（DFO）最近进行了更频繁的频率。除了重新调整变异和外围畸形外，随着patellofemoral不稳定性的扭转截骨术的引入，该指示还扩展了。这项研究的目的是评估横向开放，闭合和扭转dfo的一般和技术风险因素。总共分析了150个侧向DFO [98个开放式楔（Lowdfo）和52个关闭楔（LCWDFO）]关于骨不连的潜在危险因素，直到拆除板。骨不造成的定义是根据临床和放射学评估的骨整合失败。低dfo的分子，骨不元的速率为2％，在lcwdfo中，率高于9.6％。尼古丁滥用（P = 0.009）和更高的体重指数（P = 0.003）是重要的危险因素。患者的年龄和性别，楔形高度，铰链骨折，单极管与双帕纳尔截骨术以及额外的扭转截骨术在骨不造成方面并不显着。结论横向DFO的并发症发生率较低和不受欢迎。吸烟和肥胖与非工会的风险显着相关。扭转截骨术中相反的铰链的铰链骨折，单晶技术或完全铰链的骨切割不会对DFO中的骨不造成率产生负面影响。
Purpose Lateral distal femoral osteotomies (DFO) have recently been performed more frequently. In addition to realignment for varus and valgus deformity, the indication was extended with the introduction of torsional osteotomies in patellofemoral instability. The purpose of this study was to assess the general and technical risk factors for nonunion in lateral opening, closing and torsional DFO.Methods A total of 150 lateral DFO [98 opening wedge (LOWDFO) and 52 closing wedge (LCWDFO)] were analyzed in regard to potential risk factors for nonunion until plate removal. Nonunion was defined as failure of osseous consolidation according to clinical and radiological evaluation.Results In LOWDFO, the nonunion rate was 2%, in LCWDFO the rate was higher with 9.6%. Nicotine abuse (p = 0.009) and a higher body mass index (p = 0.003) were significant risk factors. Patient's age and gender, the wedge height, hinge fractures, monoplanar versus biplanar osteotomy as well as additional torsional osteotomies were not significant in regard of nonunion.Conclusions Lateral DFO have a low rate of complications and nonunion. Smoking and obesity were significantly associated with the risk of nonunion. Hinge fractures, monoplanar technique or complete bone cuts of the opposite hinge in torsional osteotomies did not negatively influence the nonunion rate in DFO.