经皮微型空心螺钉治疗第5跖骨基底部骨折的病例对照研究

目的：探讨第5跖骨基底干骺端骨折（Jones骨折）常规石膏固定及微创治疗的临床效果。方法：2006年至2010年分别采用石膏固定（A组）及经皮微型空心螺钉内固定（B组）治疗此类损伤41例,其中A组：男14例,女8例;年龄21～62岁,平均（32.3±8.7）岁;病程2h～3d。B组：男9例,女10例;年龄24～59岁,平均（28.8±7.9）岁;病程0.5h～2d。对2组病例进行长期随访,观察其远期疗效。结果：41例均获随访,时间3个月～2.5年,平均11.3个月。A、B2组均获得骨性愈合,B组患者术后伤口Ⅰ期甲级愈合,无并发症发生。按照Maryland足部评分系统评分,B组疗效优于A组,且愈合时间短于A组。结论：经皮微型空心螺钉微创治疗Jones骨折,操作简单易行,固定坚强,创伤小,是治疗Jones骨折的理想方法之一。

Case-control study on percutaneous treatment of foot Jones fracture with cannulated screws

Objective: To compare clinical effects between plaster fixation and cannulated screw for the treatment of Jones fracture. Methods: From 2006 to 2010,41 patients with Jones fractures were divided into 2 groups. In Group A,there were 14 males and 8 females,ranging in age from 21 to 62 years,with an average of (32.3±8.7) years;the course of disease ranged from 2 h to 3 d;the patients in Group A were treated with plaster fixation. In Group B,there were 9 males and 10 females,ranging in age from 24 to 59 years,with an average of(28.8±7.9) years;the course of disease ranged from 0.5 h to 2 d;the patients in Group B were treated with cannulated screw fixation. The patients in two groups were followed up from a long time and the long-term effects were studied. Results: All the 41 patients were followed up,from 3 months to 2.5 years,with a mean of 11.3 months. All the patients in both groups were healed. The patients in Group B got postoperative wound healing with A degree at the first stage without complications. In accordance with the Maryland Foot Score,the therapeutic effect in Group B was better than that of Group A. The healing time in Group B was shorter than that of Group A. Conclusion: Percutaneous minimally invasive treatment with micro-cannulated screw is an ideal method for the treatment of the Jones fracture.