经髓内顺行/逆行固定治疗跖骨干骨折:手术技术及临床疗效。

Closed Antegrade/Retrograde intramedullary fixation of central metatarsal fractures: Surgical technique and clinical outcomes.

机构信息

Orthopedic surgery department, Tehran University of Medical Sciences, Tehran, Iran.

Tehran University of Medical Sciences, Tehran, Iran.

出版信息

Injury. 2020 Apr;51(4):1125-1129. doi: 10.1016/j.injury.2020.03.001. Epub 2020 Mar 3.

Abstract

BACKGROUND

Intramedullary fixation with k-wires is a surgical option in the management of fractures of the shaft and neck of central metatarsals. The current study aimed at investigating the clinical outcomes of closed antegrade/retrograde intramedullary pinning technique.

PATIENTS AND METHODS

A total of 34 patients (26 males and eight females) with 58 metatarsal neck and shaft fractures (28 shaft and 26 neck fractures) were operated using the antegrade/retrograde intramedullary fixation technique. At the final follow-up visit, pain intensity was assessed using the visual analog scale (VAS) and foot function was evaluated by the American Orthopedic Foot and Ankle Society (AOFAS) forefoot scoring system.

RESULTS

Mean follow-up period was 18 months, ranged 12 to 34. Mean time to clinical fracture healing was 6.5 weeks, ranged 5 to 9. Bony union was occurred in all the cases. No surgical site infection was noted. Mean VAS score at the final follow-up visit was 0.28, ranged 0 to 3. At the final follow-up, the mean AOFAS score was 95.2, ranged 81 to 100.

CONCLUSION

Closed antegrade/retrograde intramedullary pinning is a minimally invasive technique to manage central metatarsal fractures. Using this technique, metatarsal alignment can be restored and good clinical outcome is achieved.

摘要

背景

髓内固定克氏针是治疗跖骨干和颈骨折的一种手术选择。本研究旨在探讨闭合顺行/逆行髓内钉固定技术的临床效果。

患者与方法

采用顺行/逆行髓内固定技术对 34 例(26 例男性,8 例女性)58 例跖骨颈和骨干骨折(28 例骨干骨折,26 例颈骨折)患者进行了手术治疗。在最后一次随访时,使用视觉模拟评分(VAS)评估疼痛强度,使用美国矫形足踝协会(AOFAS)前足评分系统评估足部功能。

结果

平均随访时间为 18 个月,范围为 12 至 34 个月。临床骨折愈合的平均时间为 6.5 周,范围为 5 至 9 周。所有病例均发生骨性愈合。无手术部位感染。最后一次随访时的平均 VAS 评分为 0.28,范围为 0 至 3。最后一次随访时,AOFAS 平均评分为 95.2,范围为 81 至 100。

结论

闭合顺行/逆行髓内钉固定是治疗跖骨骨折的一种微创技术。使用这种技术可以恢复跖骨的对线,获得良好的临床效果。

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