摘要
目的探讨微型锁定钢板联合克氏针固定治疗粉碎Jones骨折的临床疗效。方法 2011年1月—2016年10月,采用微型锁定钢板联合克氏针固定治疗粉碎Jones骨折25例。其中男9例,女16例;年龄16～66岁,平均31.4岁。左侧11例,右侧14例。致伤原因:扭伤21例,摔伤3例,砸伤1例。所有患者骨折线多呈Y形或T形,骨质碎裂成3块以上。其中12例合并其他部位骨折。受伤至手术时间1～9 d,平均5 d。术后9～12个月取出克氏针及微型锁定钢板。术后12个月时采用疼痛视觉模拟评分(VAS)评价疼痛情况,采用美国矫形足踝协会(AOFAS)足部评分评价功能。结果术后切口均Ⅰ期愈合。25例均获随访,随访时间12～36个月,平均21.7个月。骨折均愈合,愈合时间8～12周,平均9.4周,无不愈合、迟延愈合及畸形愈合发生。术后12个月VAS评分为(1.15±0.87)分;AOFAS足部评分为(89.45±6.24)分,获优14例、良9例、可1例、差1例,优良率92%。结论微型锁定钢板联合克氏针固定治疗粉碎Jones骨折具有操作简便、固定牢靠、愈合率高、足部功能恢复好等优点。
Objective To summarize the effectiveness of mini locking plate combined with Kirschner wire in treatment of comminuted Jones fracture. Methods Between January 2011 and October 2016, 25 cases with comminuted Jones fracture were treated with mini locking plate combined with Kirschner wire. There were 9 males and 16 females with an average age of 31.4 years（range, 16-66 years）. The fractures located on the left side in 11 cases and on the right side in14 cases. The causes of injury included spraining in 21 cases, falling down in 3 cases, and bruise in 1 case. The bone fragment of all cases was more than 3 pieces. The fracture line was mostly Y-shape or T-shape. Twelve of them were combined with other fractures. The time from injury to operation was 1-9 days（mean, 5 days）. The mini locking plate and Kirschner wire were removed at 9-12 months postoperatively. At 12 months postoperatively, the pain was evaluated by the visual analogue scale（VAS） score, and the function by the American Orthopaedic Foot Ankle Society（AOFAS） score.Results All incisions healed by first intention. All cases were followed up 12-36 months with an average of 21.7 months.Fracture union was observed in all patients without complications such as nonunion, delayed union, and malunion. The fracture union time was 8-12 weeks（mean, 9.4 weeks）. At 12 months postoperatively, the VAS score was 1.15±0.87; the AOFAS score was 89.45±6.24, and the results were excellent in 14 cases, good in 9 cases, fair in 1 case, and poor in 1 case,with an excellent and good rate of 92%. Conclusion The procedure of mini locking plate combined with Kirschner wire for comminuted Jones fracture has such advantages as convenient operation, more rigid fixation, high rate of fracture healing, and good functional recovery in foot.
作者
闫荣亮
曲家富
曹立海
刘洪达
陈江华
高岩
彭义
YAN Rongliang;QU Jiafu;CAO Lihai;LIU Hongda;CHEN Jianghua;GAO Yan;PENG Yi(Department of Foot and Ankle Surgery, the Second Hospital of Tangshan City, Tangshan Hebei, 063000, P.R.Chin)
出处
《中国修复重建外科杂志》
CAS
CSCD
北大核心
2018年第5期587-590,共4页
Chinese Journal of Reparative and Reconstructive Surgery
