应用微型钢板螺钉内固定治疗跖骨骨折

目的：探讨应用微型钢板螺钉内固定治疗跖骨骨折的临床疗效。方法2009年6月-2012年12月对84例85足跖骨骨折患者采用切开复位微型钢板螺钉内固定治疗，术后于医生指导下行康复功能锻炼。结果本组84例均获得随访，随访时间6～24个月，平均10个月。84例85足患者中一期愈合82例83足，1例术后3 d出现皮下血肿感染，1例开放性骨折术后出现皮肤坏死，采取相应治疗措施后愈合。术后定期复查X线片，骨折愈合时间为8～16周，平均13周。术后无骨折不愈合及内固定松动断裂等情况，平均14周（9～18周）可完全负重行走，平均6个月（5～12个月）取出内固定物。参照美国足踝矫形协会（AOFAS）前足评分标准评估，优29足，良49足，可5足，差2足，优良率91.76%。结论采用微型钢板螺钉内固定治疗跖骨骨折，不仅可恢复足弓生理形态，而且有利于患足关节功能恢复，骨折愈合快，值得临床推广应用。

Clinical application of minitype plate and screw fixation for treatment of metatarsal fractures

Objective To evaluate the clinical results of treating metatarsal fractures by minitype plate and screw fixation. Methods From June 2009 to December 2012, 84 cases （85 foots） with metatarsal fractures were treated with minitype plate and screw fixation, postoperative rehabilitation was applied by dortor＇s directions. Results All patients were followed up for 6 to 24 months, with an average of 10 months. In the 84 cases（85 foots）, the results were primary healing in 82 cases（83 foots）, the hematoma infection after 3 days of surgery in 1 case, and cutaneous necrosis after open fracture in 1 case. To recheck the X ray in regular after operation, all the fractures healed from 8 to 16 weeks, with an average of 13 weeks. There were no obvious complications such as malunion or nonunion, or screw loosening. All patients could walk with weight-bearing from 9 to 18 weeks, with an average of 14 weeks after operation. We took out of the minitype plate and screw from 5 to 12 months, with an average of 6 months after operation. According to AOFAS scales, the results were excellent in 29 cases, good in 49 cases, fair in 5 cases and poor in 2 cases, with an excellent and good rate of 91.76%. Conclusion Minitype plate and screw fixation is a reliable method to treat metatarsal fractures in clinical. It not only recover the arch of foot physiological shape, but also promote to recover the foot Joint function and fractures healed.