In the modern treatment of Charcot neuroarthropathy, beam screw fixation is an alternative to plate and screw fixation. Exposure is minimized for implantation, and this technique supports the longitudinal columns of the foot as a rigid load-sharing construct. A published data review identified a paucity of data regarding metatarsal intramedullary canal morphology relevant to beam screw fixation. The purpose of the present study was to describe metatarsal diaphyseal morphology qualitatively and quantitatively in an effort to provide data that can be used by surgeons when selecting axially based intramedullary fixation. Twenty fresh-frozen cadaveric below-the-knee specimens were obtained. The metatarsals were exposed, cleaned of soft tissue, and axially transected at the point of the narrowest external diameter. Next, a digital caliper was used to measure the size and shape of the diaphysis of the first through fourth metatarsals. The diaphyseal canal shape was categorized as round, oval, triangular, or pear. The widest distance between the endosteal cortical surfaces was measured. Triangular endosteal canals were only found in the first metatarsal, and the remainder of the metatarsal canals were largely round or oval. These data help to approximate the size of fixation needed to achieve maximal screw-endosteal purchase.

译文

在Charcot神经关节病的现代治疗中,梁螺钉固定是钢板和螺钉固定的替代方法。植入时将暴露降至最低,并且该技术将脚的纵向柱作为刚性载荷分担结构支撑。已发表的数据审查发现,有关与梁螺钉固定有关的跖骨髓内管形态的数据很少。本研究的目的是定性和定量地描述跖骨干端形态,以提供可供外科医生在选择基于轴向的髓内固定时使用的数据。获得了20个新鲜冷冻的尸体膝盖以下标本。暴露The骨,清洁软组织,并在最窄的外径处轴向横切。接下来,使用数字卡尺测量第一至第四跖骨的骨干的大小和形状。骨干管的形状分为圆形,椭圆形,三角形或梨形。测量了骨内膜皮质表面之间的最宽距离。三角形的骨内管仅在第一跖骨中发现,其余的跖骨大部分为圆形或椭圆形。这些数据有助于近似实现最大螺钉内骨膜购买所需的固定大小。

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