摘要
目的 观察并探讨可吸收锚钉治疗第五跖骨基底部撕脱性骨折的临床疗效.方法 回顾性分析 2021 年 6 月至 2023 年 3 月福建省立医院收治的采用可吸收锚钉切开复位内固定治疗的 16 例第五跖骨基底部撕脱性骨折患者的临床资料.其中,男性 9 例,女性7 例;年龄 22～61 岁,平均年龄 41.8 岁.观察 16 例患者的手术时间、术中出血量、术后住院时间,术后每 4～6 周定期X线复查,观察骨折愈合情况,术后 6 个月采用美国足与踝关节协会(American Orthopaedic Foot and Ankle Society,AOFAS)中足功能评分和视觉模拟评分法(visual analogue scales,VAS)评估功能恢复及疼痛情况.结果 本研究16例患者手术时间为30～60min,平均(41.6±7.4)min;术中出血量10～30ml,平均(20.6±6.6)ml;术后住院时间 1～3d,平均(1.7±0.6)d.所有患者均获得随访,随访时间 6～18 个月,平均 10.3 个月.所有患者在 6～12 周[平均(8.4±2.0)周]达到骨折临床愈合,无切口愈合不良,无骨折移位、锚钉松动等并发症.术后 6 个月中足功能AOFAS评分为 85～100 分,平均(92.5±4.3)分;术后 6 个月VAS疼痛评分为 0～3 分,平均(1.2±0.9)分.结论 可吸收锚钉切开复位内固定治疗第五跖骨基底部撕脱性骨折具有软组织剥离少、手术时间短、骨折愈合快、功能恢复好、无须二次手术等优点,是治疗第五跖骨基底部撕脱性骨折的一种有效方法.
Abstract
Objective To observe and explore the clinical effectiveness of absorbable anchors in the treatment of avulsion fracture of the base of the fifth metatarsal.Method Sixteen patients with an avulsion fracture of the fifth metatarsal base undergoing open reduction and internal fixation using absorbable anchors in our hospital from June 2021 to March 2023 were retrospectively analyzed.There were 9 males and 7 females.The age ranged from 22 to 61 years(mean 41.8 years).The operation time,intraoperative blood loss,and postoperative hospital stay were observed.X-ray examination was performed regularly after operation to observe fracture healing.The functional recovery and pain was evaluated by the midfoot function score of the American Orthopaedic Foot and Ankle Society(AOFAS)and visual analogue scale(VAS)at 6 months after operation.Result The time of operation was 30-60min[average of(41.6±7.4)min],the intraoperative blood loss was 10-30ml[average of(20.6±6.6)ml],and the postoperative hospital stay was 1-3 days[average of(1.7±0.6)days].All patients were followed up for an average of 10.3 months(range from 6-18 months).All patients achieved clinical fracture healing within 6-12 weeks,with an average healing time of(8.4±2.0)weeks.There were no complications such as poor wound healing,fracture displacement,and anchor loosening.The average AOFAS score was 92.5±4.3(range from 85-100)at 6 months after operation.The VAS pain score ranged from 0 to 3 with a mean of 1.2±0.9 at 6 months after operation.Conclusion Open reduction and internal fixation using absorbable anchors is an effective method for treating avulsion fracture of the base of the fifth metatarsal,which offers advantages such as less soft tissue dissection,shorter operation time,rapid fracture healing,good functional recovery,and no need for second operation.
维普
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