解剖锁定钩状钢板内固定联合早期负重训练对第五跖骨基底部骨折患者功能康复的影响

Effect of Anatomical Locking Compression Hook Plate Internal Fixation Combined with Early Weight-Bearing Training on Functional Rehabilitation of Patients with Basal Fracture of the Fifth Metatarsal

目的探讨解剖锁定钩状钢板(ALCHP)内固定联合早期负重训练对第五跖骨基底部骨折患者功能康复的影响.方法选取2020年4月—2022年4月我院收治的82例第五跖骨基底部骨折患者,按随机数字表法分为两组,每组41例.对照组采用ALCHP内固定治疗,观察组采用ALCHP内固定联合术后早期负重训练治疗,两组均随访3个月.比较两组患者的术后恢复情况、功能康复情况、生活质量及并发症发生情况.结果观察组的疼痛消失、肿胀消失及骨折愈合时间分别为(9.85±1.12)d、(10.32±1.15)d、(10.25±1.24)周,均短于对照组的(14.35±1.28)d、(15.31±1.32)d、(12.85±1.36)周,组间差异有统计学意义(P<0.05).观察组术后的疼痛、运动功能、外观状态及足部功能评分分别为(35.42±3.21)分、(11.75±1.32)分、(7.83±1.11)分、(46.52±4.22)分,均高于对照组的(27.91±3.13)分、(9.32±1.27)分、(6.07±1.05)分、(40.04±4.18)分,组间差异有统计学意义(P<0.05).观察组术后的生理、心理、社会及环境领域评分分别为(89.68±5.82)分、(86.79±6.34)分、(90.52±4.12)分、(92.25±3.39)分,均高于对照组的(82.41±6.25)分、(80.18±6.25)分、(83.69±6.05)分、(85.13±5.58)分,组间差异有统计学意义(P<0.05).观察组的并发症发生率低于对照组,差异有统计学意义(P<0.05).结论ALCHP内固定联合早期负重训练可加快第五跖骨基底部骨折患者骨折愈合,促进足部功能康复,减轻骨折对其生活质量的影响,且并发症少,值得临床推广使用.

Objective To investigate the effect of anatomical locking compression hook plate(ALCHP)internal fixation combined with early weight-bearing training on the functional rehabilitation of patients with basal fracture of the fifth metatarsal.Methods A total of 82 patients with basal fracture of the fifth metatarsal admitted to our hospital from April 2020 to April 2022 were selected and were divided into a control group and an observation group according to the random number table method,with 41 cases in each group.The control group was treated with ALCHP internal fixation,and the observation group was treated with ALCHP internal fixation combined with early weight-bearing training.Both groups were followed up for 3 months.The postoperative recovery,functional rehabilitation,quality of life and complications were compared between the two groups.Results The time of pain disappearance,swelling disappearance and fracture healing in the observation group were(9.85±1.12)d,(10.32±1.15)d,(10.25±1.24)weeks,respectively,which were shorter than(14.35±1.28)d,(15.31±1.32)d,(12.85±1.36)weeks in the control group,the differences between the two groups were statistically significant(P<0.05).The postoperative pain,motor function,appearance and foot function scores of the observation group were(35.42±3.21)points,(11.75±1.32)points,(7.83±1.11)points and(46.52±4.22)points,respectively,which were higher than(27.91±3.13)points,(9.32±1.27)points,(6.07±1.05)points,(40.04±4.18)points of the control group,the differences between the groups were statistically significant(P<0.05).The postoperative scores of physiological,psychological,social and environmental fields in the observation group were(89.68±5.82)points,(86.79±6.34)points,(90.52±4.12)points and(92.25±3.39)points,respectively,which were higher than(82.41±6.25)points,(80.18±6.25)points,(83.69±6.05)points,(85.13±5.58)points of the control group,the differences between the two groups were statistically significant(P<0.05).The incidence of complications in the observation group was less than that in the control group,and the difference was statistically significant(P<0.05).Conclusion ALCHP internal fixation combined with early weight-bearing training can accelerate fracture healing,promote foot function rehabilitation,reduce the impact of fracture on the quality of life in patients with basal fracture of the fifth metatarsal,and has fewer complications,which is worthy of clinical application.