经皮空心钉内固定与石膏固定治疗第五跖骨基底部骨折的疗效比较(1)
摘 要 目的：比较经皮空心钉内固定与石膏固定治疗第五跖骨基底部骨折的疗效，为临床治疗提供参考。方法：收集70例第五跖骨基底部骨折患者临床资料进行回顾性分析，根据其术后固定方式分为对照组(n=33，骨折复位后应用石膏固定)与观察组(n=37，应用经皮空心钉内固定)。比较两组足踝功能[美国矫形外科足踝协会(AOFAS)及Maryland足部评分标准(MFS)]及并发症发生率。结果：两组随访3个月后AOFAS、MFS评分均较治疗前升高，且观察组较对照组高(P<0.05)；观察组并发症总发生率较对照组低(P<0.05)。结论：相较石膏固定，第五跖骨基底部骨折患者应用经皮空心钉内固定治疗可促进足踝功能恢复，降低并发症发生率，应用效果更佳。
关键词 第五跖骨基底部骨折 经皮空心钉内固定 石膏固定 足踝功能 并发症
中图分类号：R683.42 文献标志码：B 文章编号：1006-1533(2020)21-0043-04
Comparison of percutaneous cannulated screw internal fixation and plaster fixation in the treatment of fifth metatarsal bone basal fracture
ZHANG Anjiang*， WANG Qinghua
(Department of Orthopedics， Traditional Chinese Medicine Hospital of Hukou County， Jiangxi Jiujiang 332500， China)
ABSTRACT Objective： To compare the efficacy of percutaneous cannulated screw internal fixation and plaster fixation in the treatment of fifth metatarsal bone basal fracture so as to provide reference for clinical treatment. Methods： The clinical data from 70 patients with fifth metatarsal bone basal fracture were retrospectively analyzed， and they were divided into a control group (n=33， plaster fixation after reduction of fracture) and an observation group (n=37， percutaneous cannulated screw internal fixation) based on postoperative fixation methods. The foot-ankle function (American Society of Orthopedic Foot and Ankle Surgery， AOFAS) and Maryland foot score (MFS) and the incidence of complications were compared between the two groups. Results： The AOFAS and MFS scores in the two groups at 3 months follow-up were all risen and furthermore they were higher in the observation group than the control group (P<0.05). The total incidence of complications was lower in the observation group than that the control group (P<0.05). Conclusion： Percutaneous cannulated screw internal fixation for the treatment of patients with fifth metatarsal bone basal fracture can promote the recovery of foot-ankle function and decrease the incidence of complications compared with plaster fixation and has better application effects.
KEy WORDS fifth metatarsal bone basal fracture； percutaneous cannulated screw internal fixation； plaster fixation； footankle function； complications
第五跖骨基底部骨折是足部骨折最常見类型之一，其多因肌肉牵拉、重物压迫等原因所致，于跖骨骨折中占比最高，约68%左右。该处骨折后易对患者足踝运动功能造成影响，限制其行走能力，大大降低患者生活质量，因此探索有效复位方法对促进骨折愈合，改善患者生活质量至关重要[1]。针对闭合型第五跖骨基底部骨折，经手法整合复位后临床多采用石膏进行固定，其具有良好固定性，可促使骨折处愈合[2]。随着医疗技术的提高，经皮空心钉内固定广泛用于各类型骨折固定中，其生物力学稳定性较强，固定性较佳，利于早期康复训练，加速骨折处愈合[3]。但目前临床对经皮空心钉内固定与石膏固定临床疗效对比报道较少，且现有结论报道不一，难以为临床提供有效指导。本研究旨在比较经皮空心钉内固定与石膏固定治疗第五跖骨基底部骨折的疗效，为临床治疗提供参考。, 百拇医药(张安江 王清华)
关键词 第五跖骨基底部骨折 经皮空心钉内固定 石膏固定 足踝功能 并发症
中图分类号：R683.42 文献标志码：B 文章编号：1006-1533(2020)21-0043-04
Comparison of percutaneous cannulated screw internal fixation and plaster fixation in the treatment of fifth metatarsal bone basal fracture
ZHANG Anjiang*， WANG Qinghua
(Department of Orthopedics， Traditional Chinese Medicine Hospital of Hukou County， Jiangxi Jiujiang 332500， China)
ABSTRACT Objective： To compare the efficacy of percutaneous cannulated screw internal fixation and plaster fixation in the treatment of fifth metatarsal bone basal fracture so as to provide reference for clinical treatment. Methods： The clinical data from 70 patients with fifth metatarsal bone basal fracture were retrospectively analyzed， and they were divided into a control group (n=33， plaster fixation after reduction of fracture) and an observation group (n=37， percutaneous cannulated screw internal fixation) based on postoperative fixation methods. The foot-ankle function (American Society of Orthopedic Foot and Ankle Surgery， AOFAS) and Maryland foot score (MFS) and the incidence of complications were compared between the two groups. Results： The AOFAS and MFS scores in the two groups at 3 months follow-up were all risen and furthermore they were higher in the observation group than the control group (P<0.05). The total incidence of complications was lower in the observation group than that the control group (P<0.05). Conclusion： Percutaneous cannulated screw internal fixation for the treatment of patients with fifth metatarsal bone basal fracture can promote the recovery of foot-ankle function and decrease the incidence of complications compared with plaster fixation and has better application effects.
KEy WORDS fifth metatarsal bone basal fracture； percutaneous cannulated screw internal fixation； plaster fixation； footankle function； complications
第五跖骨基底部骨折是足部骨折最常見类型之一，其多因肌肉牵拉、重物压迫等原因所致，于跖骨骨折中占比最高，约68%左右。该处骨折后易对患者足踝运动功能造成影响，限制其行走能力，大大降低患者生活质量，因此探索有效复位方法对促进骨折愈合，改善患者生活质量至关重要[1]。针对闭合型第五跖骨基底部骨折，经手法整合复位后临床多采用石膏进行固定，其具有良好固定性，可促使骨折处愈合[2]。随着医疗技术的提高，经皮空心钉内固定广泛用于各类型骨折固定中，其生物力学稳定性较强，固定性较佳，利于早期康复训练，加速骨折处愈合[3]。但目前临床对经皮空心钉内固定与石膏固定临床疗效对比报道较少，且现有结论报道不一，难以为临床提供有效指导。本研究旨在比较经皮空心钉内固定与石膏固定治疗第五跖骨基底部骨折的疗效，为临床治疗提供参考。, 百拇医药(张安江 王清华)