Miller Kaylee A, Chong Alexander C M, Uglem Timothy P
Sanford Health, Podiatry Medicine and Surgery Residency, Fargo, ND.
Sanford Health, Department of Graduate Medical Education, Fargo, ND.
Kans J Med. 2019 May 15;12(2):28-32. eCollection 2019 May.
Jones fractures pose many challenges for the treating surgeon and can cause significant disability for some patients. The aim of this study was to review the results of using a variable angle locking compression plate as an alternative fixation method in the treatment of Jones fractures.
A retrospective chart review was conducted of patients who had undergone fixation of Jones fracture with a variable angle locking compression plate from September 2012 through February 2016. Radiographs of the preoperative and six-week postoperative and postoperative follow-up outcomes, including complication and hardware removal, were collected.
Twenty-three cases met the inclusion/exclusion criteria. The overall bony union rate was 96% at six-week postoperative and 100% at 20-week postoperative. Mean age was 30 ± 16 years, and mean BMI was 30.7 ± 5.2 kg/m. Three patients (13%) had plate removal: two (9%) were due to irritation caused by shoe wearing and one patient (4%) had a skin infection (cellulitis) which was treated with intravenous antibiotics. One patient (4%) had developed deep vein thrombosis (DVT) that was resolved with anticoagulant without implant removal. No fixation loss and no associated complications developed from implant removal.
Based on our limited experience, this study provided evidence that the variable angle locking compression plate may be an alternative form of fixation for Jones fractures with a low complication rate. This procedure seemed to provide a safe, reliable method that can achieve an anatomic reduction, stable fixation, rapid healing, and good results in the treatment of Jones fractures.
琼斯骨折给治疗外科医生带来诸多挑战,可能导致部分患者出现严重残疾。本研究旨在回顾使用可变角度锁定加压钢板作为治疗琼斯骨折的替代固定方法的结果。
对2012年9月至2016年2月期间接受可变角度锁定加压钢板固定琼斯骨折的患者进行回顾性病历审查。收集术前、术后六周及术后随访结果的X线片,包括并发症和内固定取出情况。
23例符合纳入/排除标准。术后六周总体骨愈合率为96%,术后20周为100%。平均年龄为30±16岁,平均体重指数为30.7±5.2kg/m。3例患者(13%)进行了钢板取出:2例(9%)是由于穿鞋引起刺激,1例患者(4%)发生皮肤感染(蜂窝织炎),经静脉使用抗生素治疗。1例患者(4%)发生深静脉血栓形成(DVT),经抗凝治疗后缓解,未取出植入物。内固定取出未出现固定失败及相关并发症。
基于我们有限的经验,本研究表明可变角度锁定加压钢板可能是治疗琼斯骨折的一种替代固定方式,并发症发生率较低。该方法似乎提供了一种安全、可靠的方式,可实现解剖复位、稳定固定、快速愈合,并在治疗琼斯骨折方面取得良好效果。