微型钢板内固定联合自体髂骨植骨治疗陈旧性跖骨骨折  

MINIPLATE INTERNAL FIXATION AND AUTOGENOUS ILIAC BONE GRAFT IN SURGICAL TREATMENT OF OLD METATARSAL FRACTURES

作　　者：潘昊[1] 俞光荣[2] 熊文[1] 赵志明[1] 丁凡[1] 郑琼[1] 勘武生[1] 

机构地区：[1]武汉市普爱医院骨科,武汉430033 [2]同济大学附属同济医院骨科

出　　处：《中国修复重建外科杂志》2011年第7期789-791,共3页Chinese Journal of Reparative and Reconstructive Surgery

摘　　要：目的探讨微型钢板内固定联合自体髂骨植骨治疗陈旧性跖骨骨折的方法及疗效。方法 2009年5月-2010年7月,收治7例外伤致陈旧性跖骨骨折患者。男5例,女2例;年龄25～43岁,平均33岁。多发跖骨骨折5例,单发跖骨骨折2例。伤后至该次手术时间为4～12周。X线片检查示骨折断端间有少量骨痂,伴短缩、成角或旋转移位。术中切开复位后,采用微型钢板内固定联合自体髂骨植骨,植骨量1.5～2.5 cm3。术后石膏外固定4～6周,平均5周。结果术后患者切口均Ⅰ期愈合。7例均获随访,随访时间8～18个月,平均13.5个月。骨折临床愈合时间为6～12周,平均8.4周。患者站立及行走时无明显足底疼痛。术后3个月参照美国矫形足踝协会(AOFAS)中前足评分标准,评分为75～96分,平均86.4分。结论微型钢板内固定联合自体髂骨植骨治疗陈旧性跖骨骨折内固定可靠、骨折愈合率高、术后并发症少,是一种有效的治疗方法。Objective To summarize the experience of treating old metatarsal fractures with surgery methods of miniplate internal fixation and autogenous iliac bone. Methods Between May 2009 and July 2010, 7 patients with old metatarsal fractures were treated surgically, including 5 multi-metatarsal fractures and 2 single metatarsal fractures. There were 5 males and 2 females aged from 25 to 43 years （mean, 33 years）. The time from fracture to operation was 4-12 weeks. The X-ray films showed that a small amount of callus formed at both broken ends with shortening, angulation, or rotation displacement. The surgical treatments included open reduction, internal fixation by miniplate, and autogenous iliac bone graft （1.5-2.5 cm3）. The external plaster fixation was used in all patients for 4 to 6 weeks postoperatively （mean, 5 weeks）. Results All incisions healed by first intention. The 7 patients were followed up 8-18 months （mean, 13.5 months）. The clinical fracture healing time was 6 to 12 weeks postoperatively （mean, 8.4 weeks）. No pain of planta pedis occurred while standing and walking. The American Orthopaedic Foot and Ankle Society （AOFAS） mesopedes and propodium score was 75-96 （mean, 86.4）. Conclusion It has the advantages of reliable internal fixation, high fracture healing rate, less complications to treat old metatarsal fractures with surgery methods of mini plate internal fixation and autogenous il iac bone graft, so it is an effective treatment method.

关 键 词：陈旧性跖骨骨折 微型钢板 植骨术 内固定 

分 类 号：R687.3[医药卫生—骨科学]