Rettig A C, Shelbourne K D, Wilckens J
Methodist Sports Medicine Center, Indianapolis, Indiana 46202.
Am J Sports Med. 1992 Jan-Feb;20(1):50-4. doi: 10.1177/036354659202000113.
Eight athletes developed symptomatic nonunions of the base of the proximal fifth metatarsal in the metaphyseal region. All of the athletes were initially treated conservatively without success. We reviewed their case histories and outlined a simple, effective, low morbidity surgical management of these lesions. Two nonunions successfully healed with internal fixation with an intramedullary compression screw. Five additional nonunions were shelled out through a lateral incision of the peroneus brevis without disturbing its insertion. An eighth nonunion fragment was large and articulated the cuboid; it was fixed successfully with an intramedullary compression screw to preserve lateral foot mechanics. There were no complications. All patients returned to full activities 2 to 4 months after surgery.
8名运动员在第五跖骨近端干骺端区域出现了有症状的骨不连。所有运动员最初均接受保守治疗，但未成功。我们回顾了他们的病历，并概述了一种针对这些损伤的简单、有效且低发病率的手术治疗方法。2例骨不连通过髓内加压螺钉内固定成功愈合。另外5例骨不连通过在不干扰短腓骨肌止点的情况下经短腓骨肌外侧切口取出。第八例骨不连碎片较大且与骰骨相连；通过髓内加压螺钉成功固定以保留足部外侧力学结构。无并发症发生。所有患者术后2至4个月恢复了全部活动。
