缝合锚固定技术在军事训练伤致第五跖骨基底部骨折治疗中的疗效观察  

Clinical outcome of suture anchorage fixation technique in the treatment of the fifth planatarsal base fracture caused by military training injury

作　　者：刘培钊 郑益钒 陈嘉楠 裴璇 汪国栋 刘曦明 Liu Peizhao;Zheng Yifan;Chen Jianan;Pei Xuan;Wang Guodong;Liu Ximing(Department of Orthopedics,General Hospital of Central Theater Command of PLA,Wuhan 430070,China)

机构地区：[1]中国人民解放军中部战区总医院骨科,武汉430070

出　　处：《创伤外科杂志》2022年第1期12-17,共6页Journal of Traumatic Surgery

基　　金：卫勤保障能力创新与生成专项(20WQ034)。

摘　　要：目的评估缝合锚固定技术在军事训练伤致第五跖骨基底部骨折治疗中的临床疗效,并探讨其有效性、可行性和局限性。方法回顾性分析2015年1月—2021年6月中部战区总医院骨科采用缝合锚固定技术治疗的因军事训练伤致第五跖骨基底部骨折(Lawrence-Ⅰ区)患者33例,其中男性31例,女性2例;年龄18~44岁,平均25.7岁;左侧22例,右侧11例;致伤原因障碍跑11例,跳木马7例,跳伞5例,扭伤10例。记录术前住院日、切口长度、手术时间、术中出血量、术中透视次数、骨折复位满意度、骨折愈合时间、骨折愈合率及术后并发症,末次随访记录患足视觉模拟评分(VAS)和美国足踝协会(AOFAS)功能评分,并采用AOFAS评分评估患足功能。结果33例患者随访8~16个月,平均11.7个月。术前住院2~10d,平均4.2d;切口长度1.5~3.5cm,平均2.47cm;手术时间15~35min,平均23.0min;术中出血量5~20mL,平均7.6mL;术中透视次数2~6次,平均3.8次。骨折复位满意度优31例、良2例,优良率为100%;骨折愈合时间2.5~4.5个月,平均3.1个月,骨折愈合率为100%;除1例术后出现腓肠神经损伤表现外,余无明显并发症发生;末次随访VAS0~3分,平均1.1分;AOFAS评分88~100分,平均94.1分。结论缝合锚固定技术是治疗军事训练伤致第五跖骨基底部骨折的一种方式,其操作相对简单、创伤小,部分患者无需二次手术取出内固定,总体治疗效果满意,值得在军队中心医院及基层医疗机构进行推广应用。Objective To evaluate the clinical outcome of suture anchorage technique in the treatment of the fifth planatarsal base fracture by military training injury and to explore its effectiveness,feasibility and limitations.Methods A total of 33 patients with the fifth metatarsal base fracture(Zone Lawrence-I)caused by military training injuries between Jan.2015 and Jun.2021 were treated in the Department of Orthopedics,General Hospital of Central Theater Command of PLA.Among them,there were 31 males and 2 females,with an average age of 25.7 years(range,18 to 44 years);22 cases were injured in the left side and 11 cases in the right side;mechanism of injury:11 cases were injured in obstacle running,7 cases in vaulting,5 cases in brolly hop,and 10 cases of sprain during training.Pre-operative hospitalization day,incision length,surgical time,intraoperative bleeding volume,intraoperative X-ray perspective number,fracture reduction satisfaction,fracture healing time and rate,postoperative complications were registered.At the last follow-up,the visual analogue score(VAS)and the American Orthopaedic Foot&Ankle Society(AOFAS)score of the affected foot were also recorded,and the function of the affected foot was assessed by AOFAS score.Results All patients were followed up for 8 to 16 months(mean,11.7 months).Pre-operative hospitalization days ranged from 2 to 10 days(mean,4.2 days),the incision length was 1.5-3.5cm(mean,2.47cm),the operation time was 15 to 35 minutes(mean,23.0 minutes),the intraoperative bleeding volume was 5 to 20 mL(mean,7.6 mL),and the number of intraoperative X-ray fluoroscopy was 2 to 6 times(mean,3.8 times).The assessment of fracture reduction showed 31 cases of excellent and 2 cases of good.The fracture healing time was 2.5 to 4.5 months(mean,3.1 months),with 100%healing rate.No significant complications occurred,except for one case with postoperative gastrocnemius nerve injury performance.The VAS of the last follow-up was 0-3 points(mean,1.1 points),and the AOFAS score was 88 to 100 points(mean,94.1

关 键 词：军事训练伤 跖骨骨折 缝合锚 内固定 疗效 

分 类 号：R683.42[医药卫生—骨科学]