比较保守治疗与全螺纹螺钉治疗第五跖骨基底(Ⅰ区)骨折的疗效

目的比较保守治疗与全螺纹螺钉治疗第五跖骨基底(Ⅰ区)骨折的疗效。方法回顾性分析2016年7月至2021年9月55例第五跖骨基底(Ⅰ区)骨折患者的临床资料。其中手术组25例,男15例,女10例;年龄(44.3±15.7)岁,保守组患者采用石膏外固定30例,男19例,女11例;年龄(40.1±13.0)岁。比较两组患者骨折愈合时间、畸形愈合、延迟愈合、不愈合、视觉模拟量表(VAS)评分,美国足踝外科学协会(AOFAS)评分。结果55例患者随访时间为12个月。保守组延迟愈合5例,骨折不愈合1例,畸形愈合3例;手术组延迟愈合2例。手术组愈合时间(9.3±1.5)周短于保守组(11.6±2.7)周(P<0.01),AOFAS评分术后2周(P<0.01),1个月(P<0.01),3个月(P=0.02)手术组优于保守组,术后6、12个月差异计无统学意义。VAS评分术后2周(P<0.01),术后1个月(P<0.01),术后3个月(P=0.03)手术组优于保守组,术后6、12个月差异计无统学意义。结论全螺纹螺钉治疗第五基底(Ⅰ区)骨折早期疗效优于保守治疗,远期疗效相当。

Objective To compare the efficacy of the conservative treatment and the full thread screw treatment for fifth metatarsal base(Zone 1)fracture.Methods A retrospective analysis was conducted in clinical data of patients who were diagnosed with the fifth metatarsal base(Zone 1)fracture from July 2016 to September 2021 in our hospital.A total of 55 patients were enrolled in this study,including 25 patients(15 males and 10 females)in the surgery group,with an average age of(44.3±15.7)years,and 30 patients in the conservative group(19 males and 11 females)with an average age of(40.1±13.0)years.The therapeutic effects of the two groups were compared,including fracture healing time,malunion,delayed union,non-union,and Visual Analogue Score(VAS)score,Scores from the American Orthopedic Foot and Ankle Society(AOFAS).Results 55 patients were followed up for 12 months.In the conservative group,there were 5 cases of delayed union,1 case of nonunion and 3 cases of malunion.Delayed healing occurred in 2 cases in the operation group.The union time of the operation group(9.3±1.5)weeks was shorter than that of the conservative group(11.6±2.7)weeks,with statistical significance(P<0.01).AOFAS scores at 2 weeks(P<0.01),1 month(P<0.01)and 3 months(P=0.02)after surgery were better than those of conservative group,with statistical significance but there was no statistical difference at 6 months and 12 months after the surgery.The VAS score at 2 weeks(P<0.01),1 month(P<0.01)and 3 months(P=0.03)after the surgery of the surgery group were better than those of the conservative group,and there was no statistical difference between 6 months and 12 months after surgery.Conclusion The early curative effect of screw in treatment of the fifth base(zoneⅠ)fracture is better than that of the conservative treatment,but there is no significant difference in the long term.