Nice Knot缝线张力带技术辅助空心钉螺钉治疗第5跖骨基底部撕脱性骨折的疗效

Efficacy of Nice Knot suture tension band technique to assist hollow nail screw in the treatment of avulsion fracture at the base of the fifth metatarsal

目的观察Nice Knot缝线张力带技术辅助空心钉螺钉治疗第5跖骨基底部撕脱性骨折的疗效。方法第5跖骨基底部撕脱性骨折患者33例。术中采用X519韧带线行Nice Knot缝线张力带技术辅助3.0 mm AO空心钉螺钉加压固定第5跖骨基底部撕脱性骨折断端,保持骨折复位的稳定位。采用美国足踝外科协会(AOFAS)踝中足评分表进行功能评估。结果术后患者均获随访37~60(45.48±11.12)个月,切口均一期愈合,骨折端均骨性愈合。术后1年,患侧AOFAS踝中足评分高于术前[(94.36±2.77)分vs.(32.94±4.01)分](P<0.05),与健侧的(94.91±2.53)分相仿(P>0.05)。结论Nice Knot缝线张力带技术辅助空心钉螺钉治疗第5跖骨基底部撕脱性骨折具有骨折断端加压固定可靠、并发症少、早期促进骨愈合等优点。

Objective To observe the efficacy of Nice Knot suture tension band technique to assist hollow nail screw in the treatment of avulsion fracture at the base of the fifth metatarsal.Methods Thirty-three patients with avulsion fracture at the base of the fifth metatarsal were treated by Nice Knot suture tension band technique using the X519 ligamentous line to assist 3.0 mm AO cannulated screw pressurization for fixing the fractured end of avulsion fracture at the base of the fifth metatarsal bone and maintaining the stable position of fracture reduction.Functional evaluation was performed using the midfoot ankle rating scale of American Orthopedic Foot and Ankles Society(AOFAS).Results The patients were followed up for 37-60(45.48±11.12)months after operation,which showed stageⅠincision healing and bone healing at fracture end in all cases.One year after operation,the AOFAS score of midfoot ankle rating was higher than that before operation[(94.36±2.77)points vs.(32.94±4.01)points](P<0.05),which was similar to(94.91±2.53)points of the healthy side(P>0.05).Conclusion Nice Knot suture tension band technique to assist hollow nail screw in the treatment of avulsion fracture at the base of the fifth metatarsal has the advantages of reliable compression fixation at broken end of fracture,less complications,and early bone healing.