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[第五跖骨近端骨折的诊断与治疗]

[Diagnosis and treatment of proximal fifth metatarsal fracture].

作者信息

Zhang Zhen, Lyu Xin, Duan Jin-Hui

机构信息

Department of Orthopaedics, the Second Hospital of Shanxi Medical University, Taiyuan 030001, Shanxi, China.

Department of Orthopaedics, the Second Hospital of Shanxi Medical University, Taiyuan 030001, Shanxi, China;

出版信息

Zhongguo Gu Shang. 2019 Jan 25;32(1):88-91. doi: 10.3969/j.issn.1003-0034.2019.01.020.

Abstract

As one of the most common fractures of the foot, the blood supply characteristics and unique anatomy of proximal fifth metatarsal fracture makes a high risk of delayed union or non-union of fractures occurring at the junction of the diaphyseal-metaphyseal. At present, the classification system of proximal fifth metatarsal fracture is complicated and not yet unified, and Lawrence and Botte classification is more recommended. The system divides proximal fifth metatarsal fracture into three types:avulsion fractures of tuberosity(Zone I), fractures at the metaphysis-diaphysis junction, which extend into the fourth-fifth intermetatarsal facet (Zone II) and the proximal diaphyseal fractures(Zone III). Based on the classification system, each type of fracture has a corresponding treatment plan and prognosis. There are a variety of surgical methods for proximal fifth metatarsal fracture. For the fracture of Zone II and Zone III, percutaneous intramedullary screw is the first choice. In addition, clinicians should also have a thorough understanding of common complications of fracture and associated disposal methods.

摘要

作为足部最常见的骨折之一,第五跖骨近端骨折的血供特点和独特解剖结构使得骨干-干骺端交界处骨折发生延迟愈合或不愈合的风险较高。目前,第五跖骨近端骨折的分类系统复杂且尚未统一,较为推荐劳伦斯(Lawrence)和博特(Botte)分类法。该系统将第五跖骨近端骨折分为三种类型:结节撕脱骨折(I区)、干骺端-骨干交界处骨折且延伸至第四-五跖骨间关节面(II区)以及近端骨干骨折(III区)。基于该分类系统,每种类型的骨折都有相应的治疗方案和预后情况。第五跖骨近端骨折有多种手术方法。对于II区和III区骨折,经皮髓内螺钉是首选。此外,临床医生还应全面了解骨折的常见并发症及相关处理方法。

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