经皮复位空心螺钉固定治疗第五跖骨基底部撕脱性骨折

Percutaneous reduction and cannulated screw fixation for treatment of the fifth metatarsal base avulsion fractures

目的探讨踝部神经阻滞麻醉下经皮钳夹复位,空心螺钉固定治疗第五跖骨基底部撕脱骨折的临床疗效。方法选取2017年7月—2019年7月手术治疗的第五跖骨基底部撕脱骨折42例,男24例,女18例;年龄24~48岁,平均(36.3±8.9)岁。所有患者均为单纯第五跖骨基底部闭合性撕脱骨折。采用的手术方法为闭合钳夹复位、空心螺钉内固定。结果36例患者获得随访12~36个月,平均22个月。伤口1期愈合,无感染。骨折愈合时间10~12周,平均(10.5±0.3)周。患者术后平均11周(10~12周)时可完全负重行走,无明显疼痛。末次随访时36例患者采用AOFAS中前足评分标准评分86~100分,平均为(92.4±5.5)分。结论经皮钳夹空心螺钉治疗第五跖骨基底部撕脱骨折操作简单,创伤小,恢复快,可取得疗效满意,是一种可选的手术方法。

Objective To explore the clinical effect of percutaneous reduction and cannulated screw fixation on the fifth metatarsal base avulsion fractures under ankle nerve block anesthesia.Methods A total of 42 patients with only the fifth metatarsal base avulsion fractures were treated from July 2017 to July 2019.There were 24 males and 18 females with an average age of(36.3±8.9)years(ranged from 24 to 48 years).All the patients were treated with close reduction and cannulated screw fixation.Results Thirty-six patients were followed up for 22 months in average(ranged from 12 to 36 months).The wound healed at the first stage without infection.The mean time of fracture union was(10.5±0.3)weeks(ranged from 10 to 12 weeks).The mean time to start walking with load carriage was 11 weeks(ranged from 10 to 12 weeks),without obvious pain.At the last follow-up,the mean score of AOFAS Midfoot Scale was 92.4±5.5(ranged from 86 to 100).Conclusion The surgery of percutaneous reduction and cannulated screw fixation is simple and minimally invasive for the treatment of the fifth metatarsal base avulsion fractures,which can achieve fast recovery and a satisfactory effect and is an optional surgical method.