摘要
[目的]评估尺骨远端锁定加压钩板治疗第五跖骨近端基底部显著移位及粉碎性的关节内Ⅰ区骨折的有效性。[方法]回顾性分析2011年7月～2014年5月本院24例采用尺骨远端锁定加压钩板治疗急性难治性第五跖骨近端骨折的病例资料。患者平均年龄38.46岁（19～66岁）;男11例,女13例。骨折采用Lawrence and Botte分型,术后每间隔2～3周随访1次,直至骨折愈合。采用美国足踝外科协会中足（AOFAS）评分对患者康复程度进行评分。[结果]平均随访23.25个月（12～36个月）。术后平均7.42周（5～11周）骨折获得一期愈合。AOFAS评分平均为94.58分（87～100分）。术前骨折移位平均（5.08±1.14）mm（3.5～7.0 mm）,术后复位残留平均（0.38±0.49）mm（0～1 mm）,术后无显著移位（P〈0.000 1）。术前VAS评分（8.5±1.0）分（7～10分）,术后VAS评分（0.3±0.8）分（0～3分）（P〈0.000 1）。未发生感染、骨不连、骨不愈合、足畸形等并发症。术后均无皮肤激惹症状。患者在休息或者运动期间均无明显疼痛表现,未发生再骨折。[结论]应用尺骨远端锁定加压钩板治疗难治性第5跖骨近端Ⅰ区骨折能够获得满意的临床疗效,可作为一种有效的可供选择的内固定治疗方式。
[ Objective ] To evaluate the effectiveness of fixation with locking compression plate （LCP） distal ulna hook plate for treating displaced and comminuted intraarticular fractures in zone I of the proximal fifth metatarsal bone. [ Method] A retrospective review was conducted in 24 patients with refractory proximal fractures of the fifth metatarsal, who received surgical treatment by fixating with LCP distal ulna hook plate in our hospital from Jan 2011 to May 2014. The patients（ 11 males, 13 fe- males） were in average 38.46 years old with a range of 19 -66 years. All fractures of cases were identified according to Law- rence and Botte classification. All the patients were followed up after surgery at 2 or 3 week intervals till healing, meanwhile, they were also evaluated for rehabilitation degree with the American Orthopaedic Foot ＆ Ankle Society （AOFAS） of mid -foot meth- od. [ Result] The follow -up lasted for a period of 23.25 months （range, 12 -36 months）. All the fractures healed with a mean time of 7.42 weeks （ range,5 to 11 weeks）. Their average score of AOFAS was 94.58 points （ range,87 to 100 points）. The av- erage pre - operative displacement was 5.08 ± 1.14mm（3.5 -7.0mm） and the post - operative one was 0.38 ~ 0. 49mm （0 - lmm） ,no significant displacement was noticed（ P 〈 0. 0001 ）. The average pro - operative VAS was 8.5 ± 1.0（7 - 10） and post - operative one was 0. 3 ± 0. 8 （0 - 3 ） （ P 〈 0. 0001 ）. No complications such as infection, nonunion, foot deformity, skin irri- tation occurred after the operation. No pain at rest or during activities, as well as recurrence of fracture was found. [ Conclusion ] Fixation with locking compression plate （LCP） distal ulna hook plate is a useful technique to treat fractures located at zone I , especially for comminuted fractures.
出处
《中国矫形外科杂志》
CAS
CSCD
北大核心
2016年第6期509-514,共6页
Orthopedic Journal of China
