摘要
背景:第五跖骨基底部撕脱骨折是临床常见骨折,以保守治疗为主,在一些情况下需行手术治疗,目前对其手术适应证和具体手术方法尚存争议。目的:探讨第五跖骨基底部撕脱骨折的手术治疗效果与手术适应证。方法:2004年6月至2011年4月手术治疗34例第五跖骨基底部撕脱骨折患者,男18例,女16例;左侧14例,右侧20例;其中6例行克氏针张力带固定,6例行可吸收钉固定,18例行空心钉固定,3例为陈旧骨折不愈合行锁定接骨板固定,1例行骑缝钉固定。均为Dameron分型1区骨折,手术适应证为明显移位超过2mm或累及骰骨第5跖骨关节面超过30%,受伤机制均为扭伤。结果:24例患者获得随访,随访时间为8～78个月,平均27个月,伤口均一期愈合,愈合时间为2.7～3.3个月,平均3个月。根据美国足踝协会中前足功能评分为87～100分,平均(93.0±5.3)分;VAS疼痛评分为0～2分,平均(0.6±0.8)分。结论:第五跖骨基底部撕脱骨折根据骨折情况采取适合的手术治疗可取得良好的治疗效果,但需严格掌握手术适应证。
Background： The fifth metatarsal base avulsion fractures are common in clinical practice. Conservative treatment is its ma- jor treatment. But sometimes it need surgical treatment. There are still controvercy in indications and methods of surgical treatment. Objective： The aim of this study is to explore the clinical outcomes and indications of surgical treatment of avulsion fractures of the fifth metatarsal base.Methods： From June 2004 to April 2011, 34 patients with fractures of Dameron Iarea （male 18, female 16, fight side 20, left side 14） were operatively treated. Among them, 6 patients were treated by tension band, 6 patients were treated by absorbable screw, 18 patients were treated by cannulated screw, 3 patients with old fracture disunion were treated by locked plate and screw, and 1 patient was treated by staple. Indication of surgical treatment was obvious displacement more than 2 mm or the affected articular surface of the fifth metatarso-cuboid joint more than 30%. All the injuries were caused by sprain.Results： All the 24 patients were followed up from 8 to 78 months, with an mean duration of 27 months. All fractures were healed 3 months （ range from 2. 7 to 3.3 months） after treatment. The average score of the forefoot and midfoot scale （ AO- FAS） was 93.0±5.3 （range from 87 to 100）. The average score of VAS was 0. 6±0. 8 （range from 0 to 2）. Conclusions ： The clinical outcomes of the fifth metatarsal base avulsion fracture by surgical treatment are satisfactory. But the selection of indication for surgical treatment is essential.
出处
《中国骨与关节外科》
2012年第1期32-35,共4页
Chinese Journal of Bone and Joint Surgery
关键词
第五跖骨基底部
撕脱骨折
fifth metatarsal base
avulsion fracture
