[1]曹源白梁宇崔增桢符玉亮李修智吕扬**周方.空心加压埋头螺钉与解剖型锁定加压钩板治疗第五跖骨近端Lawrence Ⅰ区骨折的比较研究[J].中国微创外科杂志,2025,01(2):81-86.
　Cao Yuan,Bai Liangyu,Cui Zengzhen,et al.Comparison Study of Cannulated Compression Countersunk Head Screws and Anatomical Locking Compression Hook Plate for Fractures of Proximal Fifth Metatarsal Bone at Lawrence Zone Ⅰ[J].Chinese Journal of Minimally Invasive Surgery,2025,01(2):81-86.
点击复制

空心加压埋头螺钉与解剖型锁定加压钩板治疗第五跖骨近端Lawrence Ⅰ区骨折的比较研究()
分享到：

《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
01
期数:
2025年2期
页码:
81-86
栏目:
临床研究
出版日期:
2025-02-25

文章信息/Info

Title:
Comparison Study of Cannulated Compression Countersunk Head Screws and Anatomical Locking Compression Hook Plate for Fractures of Proximal Fifth Metatarsal Bone at Lawrence Zone Ⅰ
作者:
曹源白梁宇崔增桢符玉亮李修智吕扬**周方
(北京大学第三医院骨科骨与关节精准医学教育部工程研究中心，北京100191)
Author(s):
Cao Yuan;  Bai Liangyu;  Cui Zengzhen;  et al.
Department of Orthopedics, Peking University Third Hospital, Engineering Research Center of Bone and Joint Precision Medicine of Ministry of Education, Beijing 100191, China
关键词:
跖骨; 骨折内固定术; 螺钉; 接骨板
Keywords:
Metatarsal bone; Internal fixation of fracture; Screw; Plate
文献标志码:
A
摘要:
目的比较空心加压埋头螺钉(cannulated compression countersunk head screw，CS)与解剖型锁定加压钩板(anatomical locking compression hook plate，LCP)治疗第五跖骨近端Lawrence Ⅰ区骨折的疗效。方法回顾性分析2021年5月~2023年5月60例第五跖骨近端Ⅰ区骨折的资料，其中CS组20例，LCP组40例。采用疼痛视觉模拟评分(Visual Analogue Scale，VAS)、美国足踝外科协会(American Orthopaedic Foot and Ankle Society，AOFAS)中足评分评价术后疗效，并记录术后并发症。结果60例手术均顺利完成，CS组手术时间短于LCP组［37(15~74)min vs.50.5(28~102)min，P=0002］。骨折均愈合。术后即刻CS组VAS评分较LCP组低［3(2~5)分vs.4(2~5)分，P=0.004］，术后3、6、12个月及末次随访2组差异无显著性（P>0.05）;术后3个月CS组AOFAS中足评分较LCP组高［52(23~62)分vs.49(23~62)分，P=0038］,术后6、12个月及末次随访2组差异无显著性（P>0.05）。术后LCP组1例伤口浅表感染，3例远期慢性疼痛，6例术区异物感，其中5例1年后二次手术取出内固定物；CS组仅1例术区异物感。结论空心加压埋头螺钉与解剖型锁定加压钩板均可有效治疗第五跖骨近端Ⅰ区骨折。空心加压埋头螺钉手术时间较短，术后疼痛较轻，更利于早期功能康复。
Abstract:
ObjectiveTo compare the clinical effect between cannulated compression countersunk head screws (CS) and anatomical locking compression hook plate (LCP) for fractures of proximal fifth metatarsal bone at Lawrence zone Ⅰ.MethodsA total of 60 patients with fractures of proximal fifth metatarsal bone at Lawrence zone Ⅰ from May 2021 to May 2023 were retrospectively analyzed. Of them, 20 patients were treated by internal fixation with cannulated compression countersunk head screws (CS group), and other 40 patients were treated by internal fixation with anatomical locking compression hook plate (LCP group). The postoperative therapeutic effects were evaluated by using the Visual Analogue Scale (VAS) and the American Orthopaedic Foot and Ankle Society (AOFAS) Midfoot Scale. Incidences of postoperative complications were also recorded.ResultsThe operations were successfully completed in all the 60 patients. The operation time in the CS group was shorter than that in the LCP group ［37 (15-74) min vs. 505 (28-102) min, P=0.002］. The VAS score in the CS group immediately after surgery was lower than that in the LCP group ［3 (2-5) vs. 4 (2-5), P=0.004］, and there was no significant difference between the two groups at 3, 6, and 12 months after surgery and at the last followup (P>0.05). At the 3rd month after operation, the AOFAS score in the CS group was better than that in the LCP group ［52 (23-62) vs. 49 (23-62), P=0.038］, and there was no significant difference between the two groups at 6 and 12 months after surgery and at the last followup (P>0.05). In the LCP group, there were 1 case of superficial wound infection, 3 cases of longterm chronic pain, 6 cases of foreign body sensation, 5 cases of removal of the internal fixation by a second operation after one year postoperatively. In the CS group, there was only 1 case of foreign body sensation.ConclusionsBoth cannulated compression countersunk head screws and anatomical locking compression hook plate can effectively fix fractures of proximal fifth metatarsal bone at Lawrence zone Ⅰ. Compared with anatomical locking compression hook plate, cannulated compression countersunk head screws can shorten operation time, reduce postoperative pain, and facilitate early functional rehabilitation.

参考文献/References:

[1] 姚立炜,毛海蛟.比较保守治疗与全螺纹螺钉治疗第五跖骨基底(Ⅰ区)骨折的疗效.浙江临床医学,2023,25(5):713-714,717.
[2] Pettersen PM,Radojicic N,Grün W,et al.Proximal fifth metatarsal fractures:a retrospective study of 834 fractures with a minimum follow-up of 5 years.Foot Ankle Int,2022,43(5):602-608.
[3] Lo YC,Tai TH,Huang YM,et al.Intramedullary screw versus locking plate fixation for traumatic displaced proximal fifth metatarsal fractures:a systematic review.J Clin Med,2024,13(13):3952.
[4] 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.
[5] 刘建全,李文翠,熊建义,等.锁定加压钩接骨板治疗第5跖骨基底部骨折.中华骨与关节外科杂志,2018,11(8):570-573.
[6] 姜洪涛,薛鑫鑫,王静娜,等.横向双“8”字张力带技术在第五跖骨基底部Lawrence Ⅰ区骨折中的应用研究.中国修复重建外科杂志,2024,38(4):444-447.
[7] 熊元,方真华,王俊文,等.空心螺钉与锁定钩板治疗第五跖骨Ⅰ、Ⅱ区骨折的比较研究.中华创伤骨科杂志,2017,19(6):540-543.
[8] 张小龙,吴学建,肖鹏.空心双向加压螺钉治疗第五跖骨基底部撕脱骨折的临床分析.中国实用医刊,2014,41(5):119-120.
[9] Porter DA,Klott J.Proximal fifth metatarsal fractures in athletes:management of acute and chronic conditions.Foot Ankle Clin,2021,26(1):35-63.
[10] Pflüger P,Zyskowski M,Müller M,et al.Functional outcome of 103 fractures of the proximal fifth metatarsal bone.Eur J Med Res,2021,26(1):150.
[11] 曹清,王贵忻,田旭.急性第五跖骨近端骨折的治疗现状.中国矫形外科杂志,2022,30(11):998-1001.
[12] Wu GB,Li B,Yang YF.Comparative study of surgical and conservative treatments for fifth metatarsal base avulsion fractures (type I) in young adults or athletes.J Orthop Surg (Hong Kong),2018,26(1):2309499017747128.
[13] 马洪冬,鲁志超,殷大利,等.保守与全螺纹空心螺钉治疗第五跖骨Ekrol 2型骨折的疗效比较.中华骨科杂志,2018,38(21):1307-1313.
[14] Kim JB,Song IS,Park BS,et al.Comparison of the outcomes between headless cannulated screw fixation and fixation using a locking compression distal ulna hook plate in fracture of fifth metatarsal base.J Foot Ankle Surg,2017,56(4):713-717.

备注/Memo

备注/Memo:
基金项目：首都卫生发展科研专项(2022-2-4096)**通讯作者，Email：lvyang42@126.com
更新日期/Last Update: 2025-04-29