Matti-Rüsse植骨联合钢板内固定术治疗第五跖骨近端3区Ⅲ型骨折的疗效分析  

Effect of the operation of Matti-Rüsse bone grafting combined with plate internal fixation for proximal fifth metatarsal fracture(zone 3,typeⅢ)

作　　者：姜伟琪 刘兵 杨超 韩宁 马泽方 马翔宇 项良碧 Jiang Weiqi;Liu Bin;Yan Chao;Han Ning;Ma Zefang;Ma Xiangyu;Xiang Liangbi(Postgraduate Training Base,General Hospital of Northern Theater Command,China Medical University,Shenyang 110016,China;Department of Orthopedic,General Hospital of Northern Theater Command of PLA,Shenyang 110000,China)

机构地区：[1]中国医科大学研究生院,沈阳110000 [2]解放军北部战区总医院骨科,沈阳110000

出　　处：《中华解剖与临床杂志》2023年第4期251-255,共5页Chinese Journal of Anatomy and Clinics

基　　金：辽宁省重点研发计划(2020JH 2/10300157)。

摘　　要：目的探讨Matti-Rüsse植骨联合钢板内固定术治疗第五跖骨近端3区Ⅲ型骨折的临床疗效。方法病例系列报告。纳入北部战区总医院2020年1月—2022年1月手术治疗的10例第五跖骨近端骨干陈旧性骨折患者的临床资料。患者均男性,年龄18~24岁(平均18.9岁),均为军事训练伤所致Lawrence分区3区、TorgⅢ型骨折。所有患者采用Matti-Rüsse植骨联合钢板内固定术治疗。观察患者的骨折愈合情况及愈合时间、返回部队接受正常训练的时间、再骨折情况,以及术后并发症的发生情况,评估手术效果。结果10例患者均成功完成手术并获术后随访12~25个月;术后9例患者骨折临床愈合时间6.0~7.0周(平均6.8周),1例术后10.0周延期愈合,影像学愈合时间为6.0~10.0周(平均7.2周);返回部队训练时间为7.0~11.0周,(平均9.8周)。10名患者中无再发骨折,取骨部位均无术后并发症,2例发生术后腓肠神经炎。结论Matti-Rüsse植骨联合钢板内固定术治疗第五跖骨近端3区Ⅲ型骨折是有效的。Objective This study aims to investigate the clinical effect of Matti-Rüsse bone grafting combined with plate internal fixation on the treatment of proximal fifth metatarsal fracture(zone 3,typeⅢ).Methods This is a case series analysis study.A total of 10 soldiers with injury training who were operated in General Hospital of Northern Theater Command from January 2020 to January 2022 were enrolled in the study.The mean age was 18.9 years(18 to 24 years),and all the participants were male and had military training injuries.All the soldiers underwent open Matti-Rüsse bone grafting with plate fixation.Efficacy was evaluated by measuring healing state and healing times,time of return to before the injury training levels,recurrence or re-fracture,and postoperative complications.Results The operation was successfully performed in all patients and they were followed up(12-25 months).After 6.8 weeks(6-7 week),9 cases of fracture healed clinically,and 1 case of delayed healing to 10.0 weeks after surgery were detected.Radiographic healing was observed at an overall average of 7.2 weeks(6.0-10.0 week),and the return to training was 9.8 weeks(7.0-11.0 week).One soldier had delayed union.The post-operation complication had two neurological symptoms.Conclusion Matti-Rüsse bone grafting combined with plate internal fixation is effective for the treatment of proximal fifth metatarsal fracture(zone 3,typeⅢ).

关 键 词：骨折 应力性 跖骨 第五跖骨近端骨折 Matti-Rüsse植骨 钢板固定 

分 类 号：R687.3[医药卫生—骨科学]