可吸收锚钉治疗第五跖骨基底部撕脱性骨折的临床分析  

Clinical analysis of absorbable suture anchors in the treatment of avulsion fracture of the fifth metatarsal base

作　　者：林成 高尚君 李建华 林世水[1] Lin Cheng;Gao Shangjun;Li Jianhua;Lin Shishui(Department of Orthopedics,Fujian Provincial Hospital,Fuzhou 350001,Fujian,China)

机构地区：[1]福建省立医院骨科,福建福州350001

出　　处：《创伤与急诊电子杂志》2024年第1期53-59,共7页Journal of Trauma and Emergency(Electronic Version)

摘　　要：目的观察并探讨可吸收锚钉治疗第五跖骨基底部撕脱性骨折的临床疗效。方法回顾性分析2021年6月至2023年3月福建省立医院收治的采用可吸收锚钉切开复位内固定治疗的16例第五跖骨基底部撕脱性骨折患者的临床资料。其中,男性9例,女性7例;年龄22~61岁,平均年龄41.8岁。观察16例患者的手术时间、术中出血量、术后住院时间,术后每4~6周定期X线复查,观察骨折愈合情况,术后6个月采用美国足与踝关节协会(American Orthopaedic Foot and Ankle Society,AOFAS)中足功能评分和视觉模拟评分法(visual analogue scales,VAS)评估功能恢复及疼痛情况。结果本研究16例患者手术时间为30~60min,平均(41.6±7.4)min;术中出血量10~30ml,平均(20.6±6.6)ml;术后住院时间1~3d,平均(1.7±0.6)d。所有患者均获得随访,随访时间6~18个月,平均10.3个月。所有患者在6~12周[平均(8.4±2.0)周]达到骨折临床愈合,无切口愈合不良,无骨折移位、锚钉松动等并发症。术后6个月中足功能AOFAS评分为85~100分,平均(92.5±4.3)分;术后6个月VAS疼痛评分为0~3分,平均(1.2±0.9)分。结论可吸收锚钉切开复位内固定治疗第五跖骨基底部撕脱性骨折具有软组织剥离少、手术时间短、骨折愈合快、功能恢复好、无须二次手术等优点,是治疗第五跖骨基底部撕脱性骨折的一种有效方法。Objective To observe and explore the clinical effectiveness of absorbable anchors in the treatment of avulsion fracture of the base of the fifth metatarsal.Method Sixteen patients with an avulsion fracture of the fifth metatarsal base undergoing open reduction and internal fixation using absorbable anchors in our hospital from June 2021 to March 2023 were retrospectively analyzed.There were 9 males and 7 females.The age ranged from 22 to 61 years(mean 41.8 years).The operation time,intraoperative blood loss,and postoperative hospital stay were observed.X-ray examination was performed regularly after operation to observe fracture healing.The functional recovery and pain was evaluated by the midfoot function score of the American Orthopaedic Foot and Ankle Society(AOFAS)and visual analogue scale(VAS)at 6 months after operation.Result The time of operation was 30-60min[average of(41.6±7.4)min],the intraoperative blood loss was 10-30ml[average of(20.6±6.6)ml],and the postoperative hospital stay was 1-3 days[average of(1.7±0.6)days].All patients were followed up for an average of 10.3 months(range from 6-18 months).All patients achieved clinical fracture healing within 6-12 weeks,with an average healing time of(8.4±2.0)weeks.There were no complications such as poor wound healing,fracture displacement,and anchor loosening.The average AOFAS score was 92.5±4.3(range from 85-100)at 6 months after operation.The VAS pain score ranged from 0 to 3 with a mean of 1.2±0.9 at 6 months after operation.Conclusion Open reduction and internal fixation using absorbable anchors is an effective method for treating avulsion fracture of the base of the fifth metatarsal,which offers advantages such as less soft tissue dissection,shorter operation time,rapid fracture healing,good functional recovery,and no need for second operation.

关 键 词：第五跖骨 撕脱性骨折 可吸收锚钉 内固定 

分 类 号：R687.3[医药卫生—骨科学]