CAJ | 학술논문

目的探讨应用尺骨远端锁定加压钩钢板治疗第5跖骨基底部骨折的短期疗效. 方法 2011年10月至2012年1 1月对17例第5跖骨基底部骨折行切开复位尺骨远端锁定加压钩钢板内固定治疗,其中男6例,女11例;年龄22～72岁,平均35.8岁;按照Lawrence和Botte解剖分区:Ⅰ区14例,Ⅱ区3例;撕脱骨折块存在旋转移位大于2 mm,或波及跖骰关节面骨块移位.结果 15例患者术后获24～ 64周(平均28周)随访.所有患者术后均未发生切口感染、螺钉断裂及骨折复位丢失等并发症.X线片示骨折愈合时间平均为84 d(70 ～118 d).疗效根据美国足踝外科协会的中足评分标准评定为76 ～91分,平均87.4分.手术至恢复日常工作生活时间为91 ～137 d,平均104 d. 结论应用尺骨远端锁定加压钩钢板治疗第5跖骨基底部Ⅰ、Ⅱ区骨折,其管型配合弓齿设计能有效加压固定第5跖骨粗隆部,纠正旋转移位,维持第5跖骨基底部骨折准确复位.
목적 탐토응용척골원단쇄정가압구강판치료제5척골기저부골절적단기료효. 방법 2011년10월지2012년1 1월대17례제5척골기저부골절행절개복위척골원단쇄정가압구강판내고정치료,기중남6례,녀11례;년령22～72세,평균35.8세;안조Lawrence화Botte해부분구:Ⅰ구14례,Ⅱ구3례;시탈골절괴존재선전이위대우2 mm,혹파급척투관절면골괴이위.결과 15례환자술후획24～ 64주(평균28주)수방.소유환자술후균미발생절구감염、라정단렬급골절복위주실등병발증.X선편시골절유합시간평균위84 d(70 ～118 d).료효근거미국족과외과협회적중족평분표준평정위76 ～91분,평균87.4분.수술지회복일상공작생활시간위91 ～137 d,평균104 d. 결론 응용척골원단쇄정가압구강판치료제5척골기저부Ⅰ、Ⅱ구골절,기관형배합궁치설계능유효가압고정제5척골조륭부,규정선전이위,유지제5척골기저부골절준학복위.
Objective To evaluate the surgical treatment of the fifth metatarsal base fracture using distal ulna locking compression hook plate (DULCHP).Methods From October 2011 to November 2012,17 patients with fracture of the fifth metatarsal base were treated with open reduction and internal fixation with DULCHP.They were 6 men and 11 women,aged from 22 to 72 years (mean,35.8 years).According to the Lawrence and Botte classification of anatomic zones,14 cases had fracture in zone Ⅰ and 3 in zone Ⅱ.An initial fracture displacement more than 2 mm and significant disruption of the cuboid-fifth metatarsal joint were involved in the avulsion fractures.Results Fifteen patients were followed up for an average of 28 weeks (range,from 24 to 64 weeks).No infection,screw breakage or reduction loss occurred in this series postoperatively.The mean time to complete union as determined by X-ray ranged from 70 to 118 days (mean,84 days).By the American Orthopaedic Foot and Ankle Society (AOFAS) midfoot scale,the therapeutic efficacy scored 87.4 points on average (range,76 to 91 points).All patients reported returning to prior activities of daily living at a mean time of 104 days (range,91 to 137 days).Conclusion DULCHP fixation is an effective alternative surgical method for displaced fractures of the fifth metatarsal base at zones Ⅰ and Ⅱ,because its mini-hook tubular plate is so designed that the last hole can function as a hook for applying compression force,grasping comminuted fragments,and maintaining rotational stabilization of the metatarsal base fracture.