微型外固定支架联合克氏针治疗跖骨头关节内骨折  

Treatment of Intra-articular Fracture of Metatarsal Head Using Mini External Fixator and K-wires

作　　者：冒海军[1] 许光跃[1] 

机构地区：[1]南京大学医学院附属鼓楼医院骨科,江苏南京210008

出　　处：《实用骨科杂志》2015年第3期220-222,共3页Journal of Practical Orthopaedics

摘　　要：目的探讨微型外固定支架联合克氏针在跖骨头关节内骨折治疗中的应用和疗效。方法 2010年1月至2013年6月,应用微型外固定支架联合克氏针治疗跖骨头关节内骨折8例,男6例,女2例;年龄21~49岁,平均32岁。4~6周后拔除克氏针和去除外固定支架,进行系统功能训练。结果 2例因皮肤坏死经植皮、皮瓣修复后愈合,其余1期愈合。8例均获随访,随访时间6~10个月,平均8个月,所有骨折均顺利愈合,骨折于术后6~8周临床愈合,患者均没有明显的关节疼痛、行走疼痛。按照Maryland足部功能评价：优7例,良1例,优良率达100%。结论微型外固定支架联合克氏针是治疗跖骨头关节内骨折的有效方法,固定可靠,可早期功能锻炼,利于足部功能恢复。Objective To introduce a surgical technique combined with mini external fixator with K-wires internal fixation in the treatment of the intra-articular fracture of metatarsal head. Methods From January 2010 to June 2013,8 patients used mini external fixator and k-wires in the treatment of the intra-articular fracture of metatarsal head. There were 6 males and 2 females with a mean age of 32 years（ 21 to 49 years）. The open reduction and K-wires internal fixation were used to stabilize the fracture and mini external fixator were used to assist the reduction and fixation. Early rehabilitation was encouraged. The kwires and the external fixators were removed 4 to 6 weeks later. Results 2 patients suffered from dermatologic necrosis and healed after grafting of dermatologic flaps. The other got phase I healing. All cases were followed with a mean time of 8 months（ range from 6 to 10 months）. All the fractures healed and the meantime is 6 ~ 8 weeks. The follow-up results showed that most patients gained good results. It showed that all patients were satisfied with the treatment. Few complication happened. According to the evaluation method of function Maryland foot score： 10 cases were good,6 was general. Conclusion From our experience,the surgical technique combined mini external fixator with K-wires internal fixation is a good method for the treatment of the intra-articular fracture of metatarsal head. The advantages of mini external fixator is helpful in the reduction,fixation,earlier rehabilitation,improving function of foot.

关 键 词：跖骨头关节内骨折 微型外固定支架 固定 

分 类 号：R683.42[医药卫生—骨科学]