手术治疗创伤性第一跖骨基底部闭合性粉碎骨折脱位的临床观察

Clinical observation of surgical treatment of the first metatarsal base closed comminuted fracture and dislocation

目的分析总结手术治疗创伤性第一跖骨基底部闭合性粉碎骨折脱位的临床疗效。方法选取2012年10月至2015年12月接受切开复位内固定治疗的跖骨基底部闭合性粉碎骨折伴脱位患者24例,对所有患者术后的伤口愈合情况进行观察记录,分别于术后第6个月和第12个月进行影像学检查。同时采用美国矫形足踝协会的评分标准对足部功能进行评价。结果 1年随访结果显示所有接受手术治疗的患者其骨折均愈合,平均愈合时间为12.4±2.6周。所有患者均未发生内固定松动、钢板断裂。最后一次随访的AOFAS评分结果显示所有患者的均分为85.6±6.2分。结论切开复位内固定治疗创伤性第一跖骨基底部闭合性粉碎骨折脱位的临床疗效确切,具有操作简单,术后功能恢复快。

Objective To observe the clinical effect of the first metatarsal base closed comminuted fracture and dislocation. Methods Twenty-four patients with the first metatarsal base closed comminuted fracture and dislocation were treated by surgery of reduction and internal fixation in our hospital from October 2012 to December 2015. The clinical data of the patients analyzed respectively. The foot function was evaluated using the standard of American Orthopaedic Foot and Ankle Society. Results All the patients were followed up for one year. Radiographic healing was observed at an overall average of12.4±2.6. There were no internal fixation loosening,implant screw fracture. AOFAS score was 85.6＋6.2 at the final follow-up. Conclusion Open reduction and internal fixation for the treatment of traumatic first metatarsal basal closed comminuted fracture dislocation could result in good functional outcome with simple operation.