Herbert螺钉与克氏针治疗第五跖骨基底Ekrol 2型骨折的对比研究  

Comparative study of Herbert screw and Kirschner wire in the treatment of Ekrol 2 fracture of the fifth metatarsal base

作　　者：张磊 刘涛[1] 孔德明 肖继龙 刘晓宁[1] 戴富强 张海燕 杨洁 Zhang Lei;Liu Tao;Kong Deming;Xiao Jilong;Liu Xiaoning;Dai Fuqiang;Zhang Haiyan;Yang Jie(General Hospital of Jizhong Energy Fengfeng Group Co.,Ltd.,Handan Hebei,056002,China)

机构地区：[1]冀中能源峰峰集团有限公司总医院邯郸院区骨科,河北邯郸056002

出　　处：《生物骨科材料与临床研究》2020年第6期56-59,共4页Orthopaedic Biomechanics Materials and Clinical Study

摘　　要：目的比较研究Herbert螺钉和钛质克氏针内固定治疗第五跖骨基底Ekrol 2型骨折的疗效。方法回顾性分析2014年1月至2018年10月本院手术治疗的第五跖骨基底Ekrol 2型骨折患者44例。其中,男18例,女26例;年龄18~63岁,平均为(39.8±7.3)岁。根据内固定方式不同分为2组,Herbert螺钉组24例,克氏针组20例,将术后感染例数、完全负重时间、骨折愈合时间、骨折移位例数、患足AOFAS踝-后足评分作为观察指标,对两组病例进行对照研究。结果随访时间12~18个月,平均(15.6±2.5)个月。Herbert螺钉组病例术后感染1例,骨折移位1例,骨折愈合时间为(7.5±1.5)周,完全负重时间为(12.5±2.5)周,术后6个月AOFAS踝-后足评分为(92.2±7.7)分。克氏针组病例术后感染4例,骨折移位5例,骨折愈合时间为(10.2±1.5)周,完全负重时间为(16.8±4.3)周,术后6个月AOFAS踝-后足评分为(78.2±6.4)分。结论对于第五跖骨基底Ekrol 2型骨折采用Herbert螺钉与克氏针相比在术后感染率、固定牢固程度、骨折愈合时间、完全负重时间、术后足踝功能方面差异有统计学意义(P<0.05),Herbert螺钉具有优势。Objective To compare the therapeutic effect of Herbert screw and Kirschner wire in the treatment of Ekrol 2 fracture of the fifth metatarsal base. Methods From January 2014 to October 2018, 44 cases of Ekrol 2 fracture of the fifth metatarsal base were analyzed retrospectively. There were 18 males and 26 females, aged from 18 to 63 years, with an average age of(39.8±7.3) years. According to the different internal fixation methods, the patients were divided into two groups: Herbert screw group(24 cases) and Kirschner wire group(20 cases). The number of postoperative infection cases, time of complete weight-bearing, time of fracture healing, number of fracture displacement cases and AOFAS ankle posterior foot score of affected foot were used as the observation indexes to carry out a control study on the two groups. Results The follow-up time was 12-18 months, averaging(15.6±2.5) months. In the Herbert screw group,there were 1 case of postoperative infection, 1 case of fracture displacement,(7.5±1.5) weeks of fracture healing,(12.5±2.5) weeks of complete weight-bearing, and(92.2±7.7) points of AOFAS. In the Kirschner wire group, there were 4 cases of postoperative infection, 5 cases of fracture displacement,(10.2±1.5) weeks of fracture healing,(16.8±4.3) weeks of complete weight-bearing, and(78.2±6.4) points of AOFAS ankle posterior foot score six months after operation. Conclusion For Ekrol 2 fracture of the fifth metatarsal base, Herbert screws compared with Kirschner wire had statistically significant differences in postoperative infection rate, fixation firmness, fracture healing time, complete weight bearing time, and postoperative ankle function(P<0.05), Herbert screws have advantages.

关 键 词：HERBERT螺钉 克氏针 第五跖骨基底部骨折 Ekrol分型 AOFAS踝-后足评分 

分 类 号：R683.2[医药卫生—骨科学]