John Sealy School of Medicine, The University of Texas Medical Branch, Galveston, Texas.
Foot & Ankle Research and Innovation Lab (FARIL), Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.
JBJS Case Connect. 2023 Mar 22;13(1). doi: e22.00639. eCollection 2023 Jan 1.
A 67-year-old woman with rheumatoid arthritis underwent Lapidus hallux valgus correction. Initial realignment was unsatisfactory, so the K-wire through the first and second metatarsals was removed. As the clamp was repositioned, the second metatarsal fractured through the K-wire hole. The Lapidus procedure was completed, and then, the fracture was fixed with a percutaneous K-wire. The tarsometatarsal fusion and second metatarsal fracture healed.
Because second metatarsal structural integrity is imperative for use of the clamp, bone quality and K-wire holes from re-reduction should be considered. Although technically challenging, this case demonstrates percutaneous fracture reduction after Lapidus hallux valgus correction.
一位 67 岁的类风湿关节炎女性患者接受了 Lapidus 拇外翻矫正术。初次对线不满意，因此移除了穿过第一和第二跖骨的 K 线。当重新定位夹具时，第二跖骨穿过 K 线孔处发生骨折。Lapidus 手术完成后，用经皮 K 线固定骨折。跗跖关节融合和第二跖骨骨折愈合。
由于第二跖骨的结构完整性对于夹具的使用至关重要，因此应考虑重新复位时的骨质和 K 线孔情况。虽然技术上具有挑战性，但本病例展示了 Lapidus 拇外翻矫正术后经皮骨折复位。
