| 微型锁定钢板外置治疗第5跖骨粉碎性骨折 |
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投稿时间：2020-12-18
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| 作者 | Author | 单位 | Address | E-Mail |
| 王楠 |
WANG Nan |
浙江中医药大学附属江南医院骨科, 浙江 杭州 311021 |
Department of Orthopaedics, Jiangnan Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou 311021, Zhejiang, China |
wangnan1105@126.com |
| 王利祥 |
WANG Li-xiang |
浙江中医药大学附属江南医院骨科, 浙江 杭州 311021 |
Department of Orthopaedics, Jiangnan Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou 311021, Zhejiang, China |
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| 许良 |
XU Liang |
浙江中医药大学附属江南医院骨科, 浙江 杭州 311021 |
Department of Orthopaedics, Jiangnan Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou 311021, Zhejiang, China |
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| 吴国明 |
WU Guo-ming |
浙江中医药大学附属江南医院骨科, 浙江 杭州 311021 |
Department of Orthopaedics, Jiangnan Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou 311021, Zhejiang, China |
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| 期刊信息：《中国骨伤》2022年，第35卷，第3期，第287-291页 |
| DOI：10.12200/j.issn.1003-0034.2022.03.017 |
| 基金项目: |
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中文摘要:
目的: 探讨采用微型锁定钢板外置联合闭合复位治疗伴有严重软组织损伤的第5跖骨粉碎性骨折的临床疗效。
方法: 自2018年1月至2019年12月，采用微型锁定钢板配合闭合复位治疗13例伴有不同程度软组织损伤的第5跖骨粉碎性骨折的患者。男11例，女2例；年龄21~69岁；根据AO分型，87（S）-C2.2型9例，87（S）-C2.1型4例。未累及第5跖骨-楔骨关节面，均为第5跖骨骨干粉粹性骨折；软组织均有不同程度的损伤，3例伴有少量的皮肤软组织缺损，Ⅰ期急诊手术清创缝合后固定治疗。观察骨折愈合及并发症情况，并予末次随访时根据美国矫形外科足踝协会（American Orthopaedic Foot & Ankle Society，AOFAS）中足功能评分评价临床疗效。
结果: 所有患者获得随访，时间3~12个月。1例出现骨折延迟愈合，1例出现局部皮肤坏死，Ⅱ期植皮修复创面。无外置断钉，无感染发生。所有骨折获得骨性愈合，愈合时间8~19周。末次随访AOFAS评分49~98分，优7例，良4例，可1例，差1例。
结论: 微型锁定钢板外置联合闭合复位治疗第5跖骨粉碎性骨折，操作简便，较外固定架占位小，局部血运破坏小，有利于软组织损伤的恢复，固定可早期门诊拆除，临床适用于足背软组织损伤严重、粉碎性骨折避免剥离骨膜的患者，且占位较微型外固定架更小，便于患者早期功能锻炼。 |
| 【关键词】跖骨 骨折 外固定器 骨折,粉碎性 |
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| Clinical analysis of external micro-locking plate in the treatment of fifth metatarsal comminuted fractures |
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ABSTRACT
Objective: To explore the clinical efficacy of external micro-locking plate combined with closed reduction in the treatment of fifth metatarsal comminuted fracture with severe soft tissue injury.
Methods: From January 2018 to December 2019,13 patients received micro-locking plate combined with closed reduction treatment due to the fifth metatarsal comminuted fracture with severe soft tissue injury. There were 11 males and 2 females patients,ranging in age from 21 to 69 years. According to the fracture AO fracture classification,9 cases belonged to type 87(S)-C2.2 and 4 cases belonged to type 87(S)-C2.1. The fifth metatarsal cuneiform articular surface was not involved,and all of them were comminuted fractures of the fifth metatarsal shaft. All soft tissues were damaged to varying degrees. Three patients got small defect of skin and soft tissue,and they were treated with debridement and suture after one-stage emergency surgery. The fracture healing and complications were observed,and the clinical efficacy was evaluated according to the midfoot function score of American Orthopaedic Foot & Ankle Society (AOFAS) at the latest follow-up.
Results: All patients were followed up,and the duration ranged from 3 to 12 months. One patient had delayed union. One patient had local skin necrosis and was treated with second-stage skin grafting to repair the wound surface. No external screw breakage or infection was reported,the skin soft tissue healed satisfactorily and reached bony union,with the union time ranging from 8 to 19 weeks. The postoperative functional recovery was rated according to the midfoot score of AOFAS,the score ranged from 49 to 98,and 7 patients got an excellent result,4 good,1 fair and 1 poor.
Conclusion: The external micro-locking plate combined with closed reduction in the treatment of fifth metatarsal comminuted fracture with severe soft tissue injury has the advantages of simple operation,good stability and low infection rate,which is helpful to the repair of soft issue injury,and the fixation can be removed early in outpatient clinic. To sum up,this surgical procedure is suitable for patients with severe soft tissue injury and comminuted fracture to avoid periosteum stripping. The space occupying is smaller than the micro-external fixator,which is convenient for patients with early functional exercise. |
| KEY WORDS Metatarsal bones Fractures External fixators Fractures,comminuted |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 王楠,王利祥,许良,吴国明.微型锁定钢板外置治疗第5跖骨粉碎性骨折[J].中国骨伤,2022,35(3):287~291 |
| 英文格式: | WANG Nan,WANG Li-xiang,XU Liang,WU Guo-ming.Clinical analysis of external micro-locking plate in the treatment of fifth metatarsal comminuted fractures[J].zhongguo gu shang / China J Orthop Trauma ,2022,35(3):287~291 |
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