目的 总结采用克氏针锚钉张力带治疗第5跖骨基底部粉碎性撕脱骨折的疗效。
方法 2011年8月－2013年10月，采用克氏针锚钉张力带治疗第5跖骨基底部粉碎性撕脱骨折患者26例。其中男16例，女10例；年龄18～52岁，平均34.5岁。按照Lawrence和Botte解剖分区，均为Ⅰ区骨折。骨折块均较粉碎且移位超过2 mm，18例波及跖骰关节面骨折块移位。受伤至手术时间2～9 d，平均4 d。
结果 术后切口均Ⅰ期愈合。术后20例获随访，随访时间8～18个月，平均13个月。X线片示无内固定物断裂、骨折复位丢失、骨折不愈合或迟缓愈合等并发症发生。骨折愈合时间75～98 d，平均87 d。末次随访时，根据美国矫形足踝协会（AOFAS）中前足功能评分标准评分为85～100分，平均92分；疼痛视觉模拟评分（VAS）为0～2分，平均0.6分。
结论 应用克氏针锚钉张力带治疗第5跖骨基底部粉碎性撕脱骨折，既能起到骨折端加压作用，又避免了对皮肤的干扰刺激，疗效满意。
Citation：
黄培镇, 黄学员, 董航, 蔡群斌, 黄枫, 陈基长. 克氏针锚钉张力带治疗第五跖骨基底部粉碎性撕脱骨折. Chinese Journal of Reparative and Reconstructive Surgery, 2015, 29(6): 785-786. doi: 10.7507/1002-1892.20150168
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Copyright © the editorial department of Chinese Journal of Reparative and Reconstructive Surgery of West China Medical Publisher. All rights reserved
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Shahid M, Punwar S, Bouland C, et al. Aircast walking boot and below-knee walking cast for avulsion fractures of the base of the fifth metatarsal:a comparative cohort study. Foot Ankle Int, 2013, 34(1):75-79.
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Sarimo J, Rantanen J, Orava S, et al. Tension-band wiring for fractures of the fifth metatarsal located in the junction of the proximal metaphysis and diaphysis. Am J Sports Med, 2006, 34(3):476-480.
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Koslowsky TC, Gausepohl T, Mader K, et al. Treatment of displaced proximal fifth metatarsal fractures using a new one-step fixation technique. J Trauma, 2010, 68(1):122-125.
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李辉, 唐康来, 周建波, 等. 带线锚钉缝合固定腓骨肌腱治疗第五跖骨基底部撕脱性骨折. 中华创伤杂志, 2010, 26(12):1090-1092.
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赵晶晶, 方真华, 黄若昆, 等. 尺骨远端锁定加压钩钢板治疗第五跖骨基底部骨折的初步研究. 中华创伤骨科杂志, 2013, 15(12):1033-1036.
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- 1. Shahid M, Punwar S, Bouland C, et al. Aircast walking boot and below-knee walking cast for avulsion fractures of the base of the fifth metatarsal:a comparative cohort study. Foot Ankle Int, 2013, 34(1):75-79.
- 2. Zwitser EW, Breederveld RS. Fractures of the fifth metatarsal:diagnosis and treatment. Injury, 2010, 41(6):555-562.
- 3. Mehlhorn AT, Zwingmann J, Hirschmüller A, et al. Radiographic classification for fractures of the fifth metatarsal base. Skeletal Radiol, 2014, 43(4):467-474.
- 4. Egol K, Walsh M, Rosenblatt K, et al. Avulsion fractures of the fifth metatarsal base:a prospective outcome study. Foot Ankle Int, 2007, 28(5):581-583.
- 5. Sarimo J, Rantanen J, Orava S, et al. Tension-band wiring for fractures of the fifth metatarsal located in the junction of the proximal metaphysis and diaphysis. Am J Sports Med, 2006, 34(3):476-480.
- 6. Koslowsky TC, Gausepohl T, Mader K, et al. Treatment of displaced proximal fifth metatarsal fractures using a new one-step fixation technique. J Trauma, 2010, 68(1):122-125.
- 7. 李辉, 唐康来, 周建波, 等. 带线锚钉缝合固定腓骨肌腱治疗第五跖骨基底部撕脱性骨折. 中华创伤杂志, 2010, 26(12):1090-1092.
- 8. 赵晶晶, 方真华, 黄若昆, 等. 尺骨远端锁定加压钩钢板治疗第五跖骨基底部骨折的初步研究. 中华创伤骨科杂志, 2013, 15(12):1033-1036.
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