术前皮质类固醇注射时间和修订风险在中脚关节切除术后
Vidushan Nadarajah1, Jibraun Emerson1, Kate Panzer1
1Department of Orthopaedic Surgery, University of Virginia, Charlottesville, VA, USA.
Foot & ankle international
|January 27, 2026
概括
在中脚融合之前注射皮质类固醇的时间会影响结果. 在3个月内注射增加1年的修订风险,但90天的并发症是相似的. 建议进行仔细的规划.
科学领域:
- 整形外科手术 整形外科手术
- 药理学 药理学是指药理学的学科.
- 生物统计学 生物统计学
背景情况:
- 中脚骨关节炎 (OA) 通常在手术融合之前.
- 在中脚关节切除之前,静脉内皮质类固醇注射是常见的.
- 这些注射的最佳时间尚未确定.
研究的目的:
- 评估皮质类固醇注射时间和术后结果之间的关联.
- 根据注射时间,评估中脚关节切除后的90天并发症和1年修订率.
主要方法:
- 在82,144名接受中脚关节切除的患者 (2015-2024) 进行了回顾性队列研究.
- 根据手术前皮质类固醇注射时间分组的患者:≤1个月,>1-2个月,>2-3个月,≥3个月 (参考),没有注射.
- 多变量逻辑回归和考克斯比例危险模型分析了结果.
主要成果:
- 调整后的90天并发症几率在所有注射时间组中相似,与≥3个月的参考时间相比.
- 在手术后3个月内注射与1年修订的风险 (HRs ~1.25-1.49) 与≥3个月组相比显著更高.
- 高龄,男性性别和更高的并发症负担也增加了修订风险.
结论:
- 在足部中部关节骨折后3个月内进行手术前的皮质类固醇注射与更高的一年修复率相关.
- 根据注射时间,没有观察到90天并发症的显著差异.
- 调查结果表明,与时间相关的风险可能会影响中脚融合手术前规划,但由于数据限制,需要谨慎解释.
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