Freschi Scot A, Dodson Nic
College of Podiatric Medicine and Surgery, Des Moines University, Des Moines, IA 50312, USA.
J Foot Ankle Surg. 2008 Jul-Aug;47(4):295-8. doi: 10.1053/j.jfas.2008.04.005.
This study compared peak compression load in Newtons and stiffness in Newtons/millimeter for varying interfragmental screw sizes versus mini rail external fixation for the surgical treatment of Jones fifth metatarsal fractures. Four groups were included into this study: (1) Jones fracture with external fixation (Orthofix, Inc., McKinney, TX); (2) Jones fracture with 4.5-mm interfragmental cannulated screw; (3) Jones fracture with 5.5-mm interfragmental cannulated screw; and (4) Jones fracture with 6.5-mm interfragmental cannulated screw. There was no statistically significant difference between the peak compression achieved with the different groups of interfragmental cannulated screws: 4.5-mm interfragmental cannulated screw = 30.56 (+/- 9.40) N; 5.5-mm interfragmental cannulated screw = 30.69 (+/- 10.75) N; and 6.5-mm interfragmental cannulated screw = 32.84 (+/- 9.65) N. When comparing the compression achieved with the different groups of interfragmental cannulated screws to that achieved with the small rail external fixator (69.70 [+/- 14.69] N), a statistically significant difference was noted. There was no statistically significant difference in regard to stiffness (Newtons/millimeter) noted between the intramedullary cannulated screw groups: 4.5 cannulated screw 5.25 (+/- 1.96), 5.5 cannulated screw 5.50 (+/- 2.01), and 6.5 cannulated screw 6.75 (+/- 2.60). A statistically significant difference was noted when the stiffness (Newtons/millimeter) of the rail external fixator (12.69 (+/- 4.52) was compared to the stiffness achieved with the different interfragmental screws. The results indicated that the small rail external fixation device provided increased compression and an increased ability to resist bending when compared to the different intramedullary cannulated screws.
本研究比较了不同尺寸的骨折块间螺钉与微型轨道外固定在治疗琼斯第五跖骨骨折时的牛顿峰值压缩负荷及牛顿/毫米刚度。本研究纳入四组：（1）采用外固定治疗的琼斯骨折（Orthofix公司，得克萨斯州麦金尼）；（2）采用4.5毫米骨折块间空心螺钉治疗的琼斯骨折；（3）采用5.5毫米骨折块间空心螺钉治疗的琼斯骨折；（4）采用6.5毫米骨折块间空心螺钉治疗的琼斯骨折。不同组的骨折块间空心螺钉所实现的峰值压缩之间无统计学显著差异：4.5毫米骨折块间空心螺钉=30.56（±9.40）牛顿；5.5毫米骨折块间空心螺钉=30.69（±10.75）牛顿；6.5毫米骨折块间空心螺钉=32.84（±9.65）牛顿。将不同组的骨折块间空心螺钉所实现的压缩与微型轨道外固定器所实现的压缩（69.70[±14.69]牛顿）进行比较时，发现有统计学显著差异。髓内空心螺钉组之间在刚度（牛顿/毫米）方面无统计学显著差异：4.5毫米空心螺钉5.25（±1.96），5.5毫米空心螺钉5.50（±2.01），6.5毫米空心螺钉6.75（±2.60）。将轨道外固定器的刚度（牛顿/毫米）（12.69（±4.52））与不同骨折块间螺钉所实现的刚度进行比较时，发现有统计学显著差异。结果表明，与不同的髓内空心螺钉相比，微型轨道外固定装置提供了更大的压缩力及更强的抗弯曲能力。
