Zhao Jingjing, Yu Bin, Xie Ming, Huang Ruokun, Xiao Kai
J Am Podiatr Med Assoc. 2017 Sep;107(5):369-374. doi: 10.7547/15-208.
The distal ulna hook plate was recently introduced for the treatment of fifth metatarsal base fractures, but no special articles have reported the surgical results of the plate fixation of displaced or comminuted fifth metatarsal base fractures in zone 1, which are the most common forefoot fractures.
Twenty-one patients with Lawrence classification zone 1 fifth metatarsal base fractures with extra-articular displacement greater than 2 mm (n = 13) and intra-articular displacement fractures (n = 8) were included in the study. Patients were treated with the distal ulna hook plate. Patients were evaluated clinically and radiographically, and the functional outcomes were graded using the American Orthopaedic Foot and Ankle Society midfoot scoring system. Time to union and return to pre-injury levels of activity were calculated.
Mean American Orthopaedic Foot and Ankle Society midfoot scores were 42.25 points (range, 27-55 points) preoperatively and 93.16 points (range, 87-100 points) 1 year postoperatively. Mean time to complete union was 61.9 days (range, 52-85 days). Nineteen patients reported returning to previous activities of daily living at a mean of 79.8 days (range, 59-91 days). Two patients showed radiographic signs of mild degenerative changes and noted mild pain, and one patient experienced hardware irritation.
The distal ulna hook plate might be considered an effective surgical method for zone 1 displaced fifth metatarsal base fractures or multifragmentary, osteoporotic fifth metatarsal base fractures.
远端尺骨钩钢板最近被用于治疗第五跖骨基底骨折，但尚无专门文章报道该钢板固定第1区移位或粉碎性第五跖骨基底骨折（最常见的前足骨折）的手术结果。
本研究纳入21例Lawrence分类第1区第五跖骨基底骨折患者，其中关节外移位大于2mm者13例，关节内移位骨折8例。患者采用远端尺骨钩钢板治疗。对患者进行临床和影像学评估，并使用美国矫形足踝协会中足评分系统对功能结果进行分级。计算骨折愈合时间和恢复到伤前活动水平的时间。
术前美国矫形足踝协会中足平均评分为42.25分（范围27 - 55分），术后1年为93.16分（范围87 - 100分）。平均完全愈合时间为61.9天（范围52 - 85天）。19例患者报告平均在79.8天（范围59 - 91天）恢复到以前的日常生活活动。2例患者出现轻度退行性改变的影像学征象并伴有轻度疼痛，1例患者出现内固定刺激症状。
远端尺骨钩钢板可被认为是治疗第1区移位型第五跖骨基底骨折或多块、骨质疏松性第五跖骨基底骨折的一种有效手术方法。
