空心加压埋头螺钉与解剖型锁定加压钩板治疗第五跖骨近端Lawrence Ⅰ区骨折的比较研究  

Comparison Study of Cannulated Compression Countersunk Head Screws and Anatomical Locking Compression Hook Plate for Fractures of Proximal Fifth Metatarsal Bone at Lawrence Zone Ⅰ

作　　者：曹源[1] 白梁宇 崔增桢 符玉亮 李修智 吕扬[1] 周方[1] Cao Yuan;Bai Liangyu;Cui Zengzhen(Department of Orthopedics,Peking University Third Hospital,Engineering Research Center of Bone and Joint Precision Medicine of Ministry of Education,Beijing 100191,China)

机构地区：[1]北京大学第三医院骨科、骨与关节精准医学教育部工程研究中心,北京100191

出　　处：《中国微创外科杂志》2025年第2期81-86,共6页Chinese Journal of Minimally Invasive Surgery

基　　金：首都卫生发展科研专项(2022-2-4096)。

摘　　要：目的比较空心加压埋头螺钉(cannulated compression countersunk head screw,CS)与解剖型锁定加压钩板(anatomical locking compression hook plate,LCP)治疗第五跖骨近端LawrenceⅠ区骨折的疗效。方法回顾性分析2021年5月~2023年5月60例第五跖骨近端Ⅰ区骨折的资料,其中CS组20例,LCP组40例。采用疼痛视觉模拟评分(Visual Analogue Scale,VAS)、美国足踝外科协会(American Orthopaedic Foot and Ankle Society,AOFAS)中足评分评价术后疗效,并记录术后并发症。结果60例手术均顺利完成,CS组手术时间短于LCP组[37(15~74)min vs.50.5(28~102)min,P=0.002]。骨折均愈合。术后即刻CS组VAS评分较LCP组低[3(2~5)分vs.4(2~5)分,P=0.004],术后3、6、12个月及末次随访2组差异无显著性(P>0.05);术后3个月CS组AOFAS中足评分较LCP组高[52(23~62)分vs.49(23~62)分,P=0.038],术后6、12个月及末次随访2组差异无显著性(P>0.05)。术后LCP组1例伤口浅表感染,3例远期慢性疼痛,6例术区异物感,其中5例1年后二次手术取出内固定物;CS组仅1例术区异物感。结论空心加压埋头螺钉与解剖型锁定加压钩板均可有效治疗第五跖骨近端Ⅰ区骨折。空心加压埋头螺钉手术时间较短,术后疼痛较轻,更利于早期功能康复。Objective To compare the clinical effect between cannulated compression countersunk head screws(CS)and anatomical locking compression hook plate(LCP)for fractures of proximal fifth metatarsal bone at Lawrence zoneⅠ.Methods A total of 60 patients with fractures of proximal fifth metatarsal bone at Lawrence zoneⅠfrom May 2021 to May 2023 were retrospectively analyzed.Of them,20 patients were treated by internal fixation with cannulated compression countersunk head screws(CS group),and other 40 patients were treated by internal fixation with anatomical locking compression hook plate(LCP group).The postoperative therapeutic effects were evaluated by using the Visual Analogue Scale(VAS)and the American Orthopaedic Foot and Ankle Society(AOFAS)Midfoot Scale.Incidences of postoperative complications were also recorded.Results The operations were successfully completed in all the 60 patients.The operation time in the CS group was shorter than that in the LCP group[37(15-74)min vs.50.5(28-102)min,P=0.002].The VAS score in the CS group immediately after surgery was lower than that in the LCP group[3(2-5)vs.4(2-5),P=0.004],and there was no significant difference between the two groups at 3,6,and 12 months after surgery and at the last follow-up(P>0.05).At the 3rd month after operation,the AOFAS score in the CS group was better than that in the LCP group[52(23-62)vs.49(23-62),P=0.038],and there was no significant difference between the two groups at 6 and 12 months after surgery and at the last follow-up(P>0.05).In the LCP group,there were 1 case of superficial wound infection,3 cases of long-term chronic pain,6 cases of foreign body sensation,5 cases of removal of the internal fixation by a second operation after one year postoperatively.In the CS group,there was only 1 case of foreign body sensation.Conclusions Both cannulated compression countersunk head screws and anatomical locking compression hook plate can effectively fix fractures of proximal fifth metatarsal bone at Lawrence zoneⅠ.Compared with anatomical lock

关 键 词：跖骨 骨折内固定术 螺钉 接骨板 

分 类 号：R687.3[医药卫生—骨科学]