不同方法治疗第5跖骨基底部骨折的疗效观察

The observation of therapeutic effect of different methods on the treatment of fifth metatarsal base fracture

目的观察不同方法治疗第5跖骨基底部骨折的临床效果。方法回顾性分析2011年1月-2018年1月治疗的第5跖骨基底部骨折64例,根据治疗方法的不同分为三组:石膏外固定组、切开复位克氏针内固定组和切开复位带线锚钉内固定组。观察三组骨折愈合情况、足部功能评分、疼痛评分和并发症情况。结果石膏外固定组20例,骨折平均愈合时间(10.5±0.4)周,AOFAS评分(81.6±5.3)分,VAS评分(1.4±0.7)分,骨折再移位2例,小腿肌肉萎缩2例。切开复位克氏针内固定组12例,骨折平均愈合时间(9.5±0.6)周,AOFAS评分(88.4±3.4)分,VAS评分(1.0±0.6)分,骨折再移位1例,钉道感染1例,小腿肌肉萎缩1例。切开复位带线锚钉内固定组32例,骨折平均愈合时间(9.0±0.6)周,AOFAS评分(93.7±3.6)分,VAS评分(0.8±0.6)分,无骨折再移位、小腿肌肉萎缩等。结论切开复位锚钉内固定治疗第5跖骨基底部骨折效果好,并发症少,是首选的治疗方案。

Objective To observe the therapeutic effect of different methods on the treatment of fifth metatarsal base fracture.Methods A retrospective analysis of patients with the fifth metatarsal base fracture was researched in our hospital from January 2011 to January 2018,who was divided into three groups according to different treatment methods.The external fixation group,open reduction with Kirschner wire internal fixation group and open reduction with the suture anchor group.Fracture healing,foot function score,pain score and complications were observed in three groups.Results Twenty patients in the external fixation group had an average healing time of 10.5±0.4 weeks,an AOFAS score of 81.6±5.3,a VAS score of 1.4±0.7,2 cases of fracture relocation,and 2 cases of calf muscle atrophy.The average healing time of the open reduction with Kirschner wire internal fixation group was 9.5±0.6 weeks,the AOFAS score was 88.4±3.4,the VAS score was 1.0±0.6,the fracture was displaced in 1 case,the nail infection was in 1 case,and the calf muscle atrophy was in 1 case.The average healing time of the open reduction with the suture anchor group was 9.0±0.6 weeks,the AOFAS score was 93.7±3.6,the VAS score was 0.8±0.6,no fracture was displaced,without any calf muscle atrophy.Conclusion Open reduction with suture anchor fixation is the preferred treatment of the fifth metatarsal base fracture.