Mitchell Ronald J, Duplantier Neil L, Delgado Domenica A, Lambert Bradley S, McCulloch Patrick C, Harris Joshua D, Varner Kevin E
Orthopedics. 2017 May 1;40(3):e563-e566. doi: 10.3928/01477447-20170327-04. Epub 2017 Mar 31.
Proximal fifth metatarsal fractures, zones II and III, are commonly treated surgically, especially in elite athletes. Intramedullary screw fixation remains the most used construct despite nonunion and refracture. High tensile forces on the plantar-lateral aspect of the fifth metatarsal are difficult to control, and intramedullary screw fixation depends on ideal screw position, length, and width. The authors present a plantar plating technique with cancellous bone autograft for zones II and III proximal fifth metatarsal fractures. Rotational instability and plantar-lateral gapping are resisted by applying a compression plate to the tension side of the fracture, eliminating causes for failure. [Orthopedics. 2017; 40(3):e563-e566.].
第五跖骨近端II区和III区骨折通常采用手术治疗，尤其是在精英运动员中。尽管存在骨不连和再骨折的情况，但髓内螺钉固定仍然是最常用的固定方式。第五跖骨跖外侧方面的高张力难以控制，髓内螺钉固定取决于理想的螺钉位置、长度和宽度。作者介绍了一种用于第五跖骨近端II区和III区骨折的带松质骨自体移植的跖侧钢板固定技术。通过在骨折张力侧应用加压钢板来抵抗旋转不稳定和跖外侧间隙，消除失败原因。[《骨科》。2017年；40(3):e563 - e566。]
