Yoho Robert M, Vardaxis Vassilios, Dikis Jeffrey
College of Podiatric Medicine and Surgery, Des Moines University, 3200 Grand Avenue, Des Moines, IA 60312, United States.
College of Health Sciences - Physical Therapy Program, Des Moines University, 3200 Grand Avenue, Des Moines, IA 50312, United States.
Foot (Edinb). 2015 Dec;25(4):215-9. doi: 10.1016/j.foot.2015.05.006. Epub 2015 May 22.
The fifth metatarsal Jones fracture is a unique injury. Previous studies have identified possible biomechanical risk factors related to this fracture, as well as potential subsequent effects on bone healing complications. The purpose of this retrospective study was to determine the effect of metatarsus adductus (MAA) on bone healing in patients following intramedullary screw fixation of the Jones fracture.
This study reviewed 14 Jones fractures that underwent intramedullary screw fixation. Serial radiographs taken approximately every two weeks were evaluated to determine bone healing time (BHT). Weight-bearing antero-posterior radiographs were used to determine the MAA using standard osseous landmarks.
There was a strong positive correlation between MAA and BHT. Moderate correlations were also found between age and BHT and between age and MAA. A prediction algorithm derived from the regression model shows that 63.2% of the variability in the Jones fracture healing time (BHT) can be predicted by a minimum of 22.7 days increased by an average of 1.23 days for each degree of MAA.
This study suggests healing time in Jones fractures to be highly related to the MAA following intramedullary screw fixation. The ability to predict osseous union of Jones fracture offers advantages such as patient expectations as well as individualized rehabilitation programs.
第五跖骨琼斯骨折是一种独特的损伤。以往的研究已经确定了与这种骨折相关的可能的生物力学风险因素,以及对骨愈合并发症的潜在后续影响。这项回顾性研究的目的是确定在琼斯骨折髓内螺钉固定术后,跖骨内收(MAA)对患者骨愈合的影响。
本研究回顾了14例接受髓内螺钉固定的琼斯骨折病例。对大约每两周拍摄的系列X线片进行评估,以确定骨愈合时间(BHT)。使用标准骨性标志,通过负重前后位X线片来确定MAA。
MAA与BHT之间存在强正相关。年龄与BHT之间以及年龄与MAA之间也存在中度相关性。从回归模型得出的预测算法表明,琼斯骨折愈合时间(BHT)变异性的63.2%可以通过MAA每增加一度平均增加1.23天,至少增加22.7天来预测。
本研究表明,髓内螺钉固定术后琼斯骨折的愈合时间与MAA高度相关。预测琼斯骨折骨愈合的能力具有诸多优势,如患者期望以及个性化康复计划等。