中国修复重建外科杂志

中国修复重建外科杂志

微型锁定钢板联合克氏针治疗粉碎 Jones 骨折疗效分析

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目的 探讨微型锁定钢板联合克氏针固定治疗粉碎 Jones 骨折的临床疗效。 方法 2011 年 1 月—2016 年 10 月,采用微型锁定钢板联合克氏针固定治疗粉碎 Jones 骨折 25 例。其中男 9 例,女 16 例;年龄 16~66 岁,平均 31.4 岁。左侧 11 例,右侧 14 例。致伤原因:扭伤 21 例,摔伤 3 例,砸伤 1 例。所有患者骨折线多呈 Y 形或 T 形,骨质碎裂成 3 块以上。其中 12 例合并其他部位骨折。受伤至手术时间 1~9 d,平均 5 d。术后 9~12 个月取出克氏针及微型锁定钢板。术后 12 个月时采用疼痛视觉模拟评分(VAS)评价疼痛情况,采用美国矫形足踝协会(AOFAS)足部评分评价功能。 结果 术后切口均Ⅰ期愈合。25 例均获随访,随访时间 12~36 个月,平均 21.7 个月。骨折均获愈合,愈合时间 8~12 周,平均 9.4 周,无不愈合、迟延愈合及畸形愈合发生。术后 12 个月 VAS 评分为(1.15±0.87)分;AOFAS 足部评分为(89.45±6.24)分,获优 14 例、良 9 例、可 1 例、差 1 例,优良率 92%。 结论 微型锁定钢板联合克氏针固定治疗粉碎 Jones 骨折具有操作简便、固定牢靠、愈合率高、足部功能恢复好等优点。

Objective To summarize the effectiveness of mini locking plate combined with Kirschner wire in treatment of comminuted Jones fracture. Methods Between January 2011 and October 2016, 25 cases with comminuted Jones fracture were treated with mini locking plate combined with Kirschner wire. There were 9 males and 16 females with an average age of 31.4 years (range, 16-66 years). The fractures located on the left side in 11 cases and on the right side in 14 cases. The causes of injury included spraining in 21 cases, falling down in 3 cases, and bruise in 1 case. The bone fragment of all cases was more than 3 pieces. The fracture line was mostly Y-shape or T-shape. Twelve of them were combined with other fractures. The time from injury to operation was 1-9 days (mean, 5 days). The mini locking plate and Kirschner wire were removed at 9-12 months postoperatively. At 12 months postoperatively, the pain was evaluated by the visual analogue scale (VAS) score, and the function by the American Orthopaedic Foot & Ankle Society (AOFAS) score. Results All incisions healed by first intention. All cases were followed up 12-36 months with an average of 21.7 months. Fracture union was observed in all patients without complications such as nonunion, delayed union, and malunion. The fracture union time was 8-12 weeks (mean, 9.4 weeks). At 12 months postoperatively, the VAS score was 1.15±0.87; the AOFAS score was 89.45±6.24, and the results were excellent in 14 cases, good in 9 cases, fair in 1 case, and poor in 1 case, with an excellent and good rate of 92%. Conclusion The procedure of using mini locking plate combined with Kirschner wire to treat comminuted Jones fracture has such advantages as convenient operation, more rigid fixation, high rate of fracture healing, and good functional recovery in foot.

关键词: Jones 骨折; 微型锁定钢板; 克氏针; 内固定

Key words: Jones fracture; mini locking plate; Kirschner wire; internal fixation

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