Thermal Properties of First Metatarsal Osteotomies
Thermal Properties of First Metatarsal Osteotomies
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DOI：
10.1053/j.jfas.2009.03.009
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发表时间：
2009-07-01
影响因子：
1.3
通讯作者：
Dalmia, Lopa
中科院分区：
文献类型：
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作者：
Hall, Patrick B.;Landsman, Adam;Dalmia, Lopa
每当进行截骨术、插入克氏针、钻孔以及用毛刺减少骨头时都会产生热量。尽管之前的研究人员已经确定了造成骨损伤所需的时间和温度的组合，但据我们所知，尚未有人具体研究在足部进行截骨术时产生的热量是否达到足以损伤骨组织的水平。为此，作者设计了一项实验来测量尸体第一跖骨温度的变化，以及与骨温度升降相关的时间，以响应在锯片同时进行盐溶液冲洗和不进行盐溶液冲洗的情况下进行的截骨术。该研究是在一对匹配的尸体骨（对侧肢体）上进行的，其中一侧用生理盐水溶液冲洗，另一侧在没有盐水溶液冲洗的情况下进行截骨。在第一个跖骨样本的 3 个部位（特别是头部、中骨干和基部）进行了背侧和足底截骨，分析中总共包括 112 个截骨。无论是否使用盐水溶液冲洗，骨标本都没有达到已知与截骨术期间热损伤相关的温度。然而，使用盐水溶液冲洗确实降低了截骨术期间骨峰值温度，并且使用冲洗也缩短了持续温度升高的持续时间。临床证据等级：5（足踝外科杂志 48(4):432-438, 2009）
Heat is generated whenever osteotomies are created, Kirschner wires are inserted, holes are drilled, and when bone is reduced with a burr. Although previous investigators have determined the combination of time and temperature necessary to cause bone injury, to our knowledge, no one has yet specifically studied whether the heat generated when osteotomies are performed in the foot reaches sufficient levels to damage osseous tissue. Toward that end, the authors designed an experiment to measure the change in cadaveric first metatarsal temperature, and the time associated with the rise and fall of the bone temperature, in response to osteotomies performed with and without concomitant saline solution irrigation of the saw blade. The study was conducted on matched pairs (contralateral limbs) of cadaveric bone, with one side being irrigated with normal saline solution and the other side being osteotomized without saline solution irrigation. Osteotomies were created dorsally and plantarly at 3 sites in the first metatarsal specimens, specifically at the head, mid-diaphysis, and base, and a total of 112 osteotomies were included in the analyses. Pegardless of whether saline solution irrigation was used, none of the bone specimens reached a temperature known to be associated with thermal injury during osteotomy. The use of saline solution irrigation did, however, provide a reduction in peak bone temperature during osteotomy, and the duration of sustained temperature elevation was also shortened with the use of irrigation. Level of Clinical Evidence: 5 (The Journal of Foot & Ankle Surgery 48(4):432-438, 2009)