缝合锚与克氏针张力带内固定治疗第五跖骨基底部骨折的比较研究

Comparative study of suture anchor and Kirschner wire tension band internal fixation for the treatment of Fifth humeral base fracture

目的比较缝合锚与克氏针张力带内固定治疗第五跖骨基底部骨折的疗效。方法回顾性分析2013年6月至2018年10月接受治疗并获得完整随访的33例Lawrence-Ⅰ区第五跖骨基底部骨折患者的病例资料,根据内固定的方式不同分为缝合锚组(15例)和克氏针张力带组(18例)。记录并比较两组术中手术时间、骨折复位满意程度、愈合时间及术后功能优良率。结果缝合锚组和克氏针张力带组在骨折复位满意程度、愈合时间、术后并发症方面无差异,缝合锚组手术时间比克氏针张力带组短,两组手术时间比较差异具有统计学意义(t=-8.714,P<0.05),手术切口长度比较具有统计意义(t=-13.867,P<0.05),术中透视次数比较具有统计意义(t=-6.834,P<0.05),末次随访,按美国足踝协会(AOFAS)中前足功能评分,两组功能恢复差异有统计学意义(t=4.948,P<0.05)。结论缝合锚具有简便、微创、有效、无需再取内固定等特点,与克氏针张力带相比,减少了手术时间,缩短手术切口长度并减少了透视次数,是治疗第五跖骨基底部骨折的一种有效方法。

Objective Comparison of suture anchor and Kirschner wire tension band internal fixation for the treatment of Fifth humeral base fracture.Methods Retrospective analysis of 33 patients with a fifth tibiofibular basal fracture in Lawrence-I were underwent treatment and complete follow-up from June 2013 to October 2018 according to the way of internal fixation,patients were divided into suture anchor group(15 cases)and Kirschner wire tension band group(18 cases).The intraoperative time,fracture reduction satisfaction,injury healing time and postoperative functional excellence rate were recorded and compared between two groups.Results There was no difference in the degree of fracture reduction,healing time,and postoperative complications between the suture anchor group and the Kirschner wire tension band group,The difference between the operation time of two groups was statistically significant(t=-8.714,P<0.05).The length of the surgical incision was statistically significant(t=-13.867,P<0.05).Comparison of intraoperative perspectives is statistically significant(t=-6.834,P<0.05).At the last follow-up,according to the forefoot function score of the American Foot and Ankle Association(AOFAS),the difference in functional recovery between the two groups was statistically significant(t=4.948,P<0.05).Conclusion Suture anchor is simple,minimally invasive,effective and no need to take internal fixation.Compared with Kirschner wire tension band,the operation time is reduced,the length of the surgical incision is shortened,and the number of fluoroscopy is reduced.It is an effective method for the treatment of the fifth metatarsal humeral fracture.