The comparative study of clinical outcomes among early functional treatment, immobilization treatment and ulnar plate fixation for displaced or comminution fifth metatarsal base fractures

IF 1.3 4区 医学 Q2 Medicine
Kunpeng Leng MD, Yang Liu MD, Yutong Meng MD, Junlin Zhou MD
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引用次数: 0

Abstract

The optimal treatment for displaced or comminution fifth metatarsal base fractures remain debated. Ninety displaced or comminution fifth metatarsal base fractures patients were randomly selected into three groups: the ulnar hook plate fixation group (n=30), the immobilization treatment group (n=18), and the early functional group (n=30). The assessed factors included the duration until union, time to resume daily activities, American Orthopaedic Foot and Ankle Society (AOFAS) scores, Foot and Ankle Disability Index (FADI) scores, visual analog scale (VAS) ratings and occurrence of complications. The VAS scores showed no significant differences observed among the three treatments. The mean AOFAS score and mean FADI after treatment in the plate group and exhibited significant better than that of the immobilization group and the early functional group at 1 moth, 3 months and 6 months (P˂0.05). After a duration of 12 months, all three treatments exhibited comparable outcomes and facilitated restoration of daily activities. In the plate group, one patient developed a wound infection, one patient experienced sural nerve injury or irritation, and three patients exhibited implant prominence. One patient encountered nonunion in the immobilization group.The union time and the time of return to daily activities and the early functional group exhibited significant shorter durations than that of the immobilization group and the plate group(P˂0.05). Overall, the early functional treatment is recommended for managing displaced or comminution fifth metatarsal base fractures.
早期功能治疗、固定治疗和尺钢板内固定治疗第5跖底移位或粉碎性骨折的临床疗效比较研究。
移位或粉碎性第五跖骨基部骨折的最佳治疗方法仍存在争议。将90例移位或粉碎性第五跖骨骨折患者随机分为三组:尺骨钩钢板固定组(n=30)、固定治疗组(n=18)和早期功能组(n=30)。评估因素包括愈合前持续时间、恢复日常活动时间、美国骨科足踝协会(AOFAS)评分、足踝残疾指数(FADI)评分、视觉模拟量表(VAS)评分和并发症发生情况。三组VAS评分差异无统计学意义。钢板组治疗后1个月、3个月和6个月的平均AOFAS评分和平均FADI均显著优于固定化组和早期功能组(P小于0.05)。12个月后,所有三种治疗都显示出相当的结果,并促进了日常活动的恢复。钢板组中,1例患者出现伤口感染,1例患者出现腓肠神经损伤或刺激,3例患者出现种植体突出。固定组1例患者出现骨不连。骨愈合时间、恢复日常活动时间和早期功能组明显短于固定术组和钢板组(P小于0.05)。总的来说,早期功能治疗被推荐用于治疗移位或粉碎性第五跖骨骨折。证据等级:III。
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来源期刊
Journal of Foot & Ankle Surgery
Journal of Foot & Ankle Surgery ORTHOPEDICS-SURGERY
CiteScore
2.30
自引率
7.70%
发文量
234
审稿时长
29.8 weeks
期刊介绍: The Journal of Foot & Ankle Surgery is the leading source for original, clinically-focused articles on the surgical and medical management of the foot and ankle. Each bi-monthly, peer-reviewed issue addresses relevant topics to the profession, such as: adult reconstruction of the forefoot; adult reconstruction of the hindfoot and ankle; diabetes; medicine/rheumatology; pediatrics; research; sports medicine; trauma; and tumors.
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