| 张琳袁,沈超,崔崟,等.解剖型锁定加压钩钢板与BOLD螺钉内固定治疗第五跖骨近端Lawrence-Botte Ⅰ/Ⅱ区骨折的疗效比较.骨科,2022,13(4): 309-314. |
| 解剖型锁定加压钩钢板与BOLD螺钉内固定治疗第五跖骨近端Lawrence-Botte Ⅰ/Ⅱ区骨折的疗效比较 |
| Comparison of Anatomical Locking Compression Hook Plate and BOLD Screw Internal Fixation in the Treatment of Lawrence-Botte Zone Ⅰ/Ⅱ Fractures of the Proximal Fifth Metatarsal |
| 投稿时间：2022-05-22 |
| DOI：10.3969/j.issn.1674-8573.2022.04.005 |
| 中文关键词: 跖骨 骨折内固定术 接骨板 螺钉 |
| 英文关键词: Metatarsus Fracture internal fixation Plate Screw |
| 基金项目:上海市卫生健康委先进适宜推广项目（2019SY069）；上海市卫生健康委员会科研课题基金（20204Y0478） |
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| 中文摘要: |
| 目的 比较解剖型锁定加压钩钢板（anatomical locking compression hook plate，ALCHP）与BOLD螺钉内固定治疗第五跖骨近端Lawrence-Botte Ⅰ/Ⅱ区骨折的临床疗效。方法 回顾性分析2017年1月至2020年12月在我院行手术内固定的59例第五跖骨近端Lawrence-Botte Ⅰ/Ⅱ区骨折病人，依骨折内固定方式分为ALCHP组（25例）与BOLD螺钉组（34例）。记录病人一般资料、手术时间、术中出血量、骨折愈合时间、随访时间，术后3个月、6个月及末次随访时的美国足踝外科医师协会（American Orthopaedic Foot and Ankle Society，AOFAS）踝与后足功能评分系统评分，记录随访过程中并发症情况。结果 两组病人手术均顺利完成，ALCHP组手术时间长于BOLD组[（43.8±9.2） min vs. （35.6±7.5） min]（P＜0.05），两组术中出血量的差异无统计学意义（P＞0.05）。所有病人均获得随访，两组随访时间的差异无统计学意义（P＞0.05）。随访过程中骨折均愈合，两组骨折愈合时间[（9.9±1.5）周 vs. （10.7±3.1）周]的差异无统计学意义（P＞0.05）。术后ALCHP组1例出现伤口周缘红肿，BOLD螺钉组2例出现螺钉松动伴轻微退钉，未影响骨折愈合，无内植物感染、腓肠神经分支损伤发生。术后3个月，ALCHP组AOFAS评分优于BOLD螺钉组（P＜0.05），术后6个月及末次随访两组AOFAS评分的差异无统计学意义（P＞0.05）。结论 ALCHP与BOLD螺钉均可有效固定第五跖骨近端Lawrence-Botte Ⅰ/Ⅱ区骨折，获得良好功能恢复。两种内固定方式在手术并发症、远期功能恢复上无差异，但ALCHP属坚强固定，更有利于术后早期功能恢复。 |
| 英文摘要: |
| Objective To compare the clinical effect of anatomical locking compression hook plate (ALCHP) and BOLD screw internal fixation in the treatment of Lawrence-Botte Ⅰ/Ⅱ fracture of the proximal fifth metatarsal. Methods Totally, 59 patients with Lawrence-Botte Ⅰ/Ⅱ fracture of the proximal fifth metatarsal, who underwent internal fixation in our hospital from January 2017 to December 2020, were retrospectively analyzed. They were divided into ALCHP group (25 cases) and BOLD group (34 cases) according to the internal fixation methods. The general information, operation time, intraoperative blood loss, bone healing time and follow-up time were recorded. The American Orthopaedic Foot and Ankle Society (AOFAS) functional score was performed at 3rd month, 6th month after operation and the last follow-up, and the complications during the follow-up period were recorded. Results The operation of both groups was successfully completed. The operation time in ALCHP group [(43.8±9.2) min] was longer than that in BOLD group [(35.6±7.5) min] (P＜0.05). There was no significant difference in blood loss between the two groups (P＞0.05). All patients were followed up, and there was no statistically significant difference in follow-up time between the two groups (P＞0.05). During the follow-up period, all the fractures healed, and there was no statistically significant difference in bone healing time between the two groups [(9.9±1.5) weeks vs. (10.7±3.1) weeks, P＞0.05]. After operation, there was redness and swelling around the wound in 1 case in ALCHP group, and screw loosening with slight screw withdrawal in 2 cases in BOLD group, which did not affect the bone healing, and there was no implant infection or sural nerve injury. At 3rd month after operation, the AOFAS score in ALCHP group was better than that in BOLD group (P＜0.05), and there was no significant difference in AOFAS score between the two groups at 6th month after operation and at the last follow-up (P＞0.05). Conclusion ALCHP and BOLD screws can effectively fix Lawrence-Botte Ⅰ/Ⅱ fracture of the proximal fifth metatarsal, and achieve good functional recovery. There is no difference in complications and long-term functional recovery between the two internal fixation methods, but ALCHP is a strong fixation, which is more conducive to early postoperative functional recovery. |
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