临床外科杂志 ›› 2025, Vol. 33 ›› Issue (10): 1109-1112.doi: 10.3969/j.issn.1005-6483.20241515

• 论著 • 上一篇    下一篇

体表精准定位经皮螺钉固定治疗Jones骨折的疗效分析

吴永军 赵猛 罗斌 吴彪 杨祯东 王玉峰   

  1. 442000 湖北十堰,十堰市太和医院(湖北医药学院附属医院)创伤骨科
  • 收稿日期:2024-09-13 出版日期:2025-11-11 发布日期:2025-11-11
  • 通讯作者: 赵猛,Email:zmzm0655@163.com

Analysis of the therapeutic effect of precise surface positioning method in percutaneous screw fixation for Jones fracture

WU Yongjun,ZHAO Meng,LUO Bin,WU Biao,YANG Zhendong,WANG Yufeng   

  1. Department of Traumatic Orthopedics,Taihe Hospital,Affiliated to Hubei University of Medicine,Hubei,Shiyan 442000,China
  • Received:2024-09-13 Online:2025-11-11 Published:2025-11-11

摘要: 目的 探讨体表精准定位经皮微创空芯螺钉治疗Jones骨折的临床疗效。方法 2021年9月~2023年12月间收治的Jones骨折病人46例。按照治疗方式的不同将病人分为两组:螺钉组24例,采用经皮螺钉固定;张力带组22例,采用切开复位张力带固定。记录并比较两组病人的一般情况、手术时间、住院时间、骨折复位质量、术后完全负重时间、骨折愈合时间、并发症,采用美国足踝外科协会(AOFAS)系统评定足功能恢复情况。结果 两组病人术前一般资料比较差异无统计学意义(P>0.05)。螺钉组和张力带组的手术时间分别为(32.96±5.35)分钟和(47.27±9.42)分钟,住院时间分别为(5.75±1.18)天和(7.68±2.05)天,术后完全负重时间分别为(6.47±0.73)周和(7.29±1.66)周,骨折愈合时间分别为(3.31±0.68)个月和(4.29±1.29)个月,AOFAS评分分别为(89.13±2.62)分和(79.59±4.49)分,两组比较差异有统计学意义(P<0.05);张力带组术中骨折复位质量优于螺钉组(P<0.05);螺钉组未发生并发症,张力带组感染和克氏针松动各1例。结论 体表精准定位法经皮微创应用空芯螺钉治疗Jones骨折,定位精准、操作简单、创伤小、快速康复,安全有效,但需根据骨折类型严格控制适应证。

关键词: Jones骨折, 微创, 螺钉, 体表定位, 张力带

Abstract: Objective To explore the efficacy of precise surface positioning method in percutaneous screw fixation for Jones fracture.Methods Data of 46 patients with Jones fractures admitted to our hospital from September 2021 to December 2023 were retrospectively analyzed.According to the different treatment methods,the patients were divided into screw groups (24 patients fixed by percutaneous screws) and tension band groups (22 patients fixed by incision and reset tension band).The general conditions,follow-up time,surgical time,hospitalization time,fracture reduction quality,postoperative complete weight-bearing time,fracture healing time,and complications in the two groups were recorded and compared.The American Association of Foot and Ankle Surgery (AOFAS) system was used to assess the recovery of foot function.Results There was no statistically significant difference in the general data before the operation between the two groups of patients (P>0.05).The follow-up time of the two groups was 6 to 24 months.Compared with the tension band group,the screw group had shorter operation time[(32.96±5.35)min vs.(47.27±9.42)min],shorter hospitalization time [(5.75±1.18)d vs.(7.68±2.05)d],earlier postoperative complete weight-bearing time[(6.47±0.73)w vs.(7.29±1.66)w],faster fracture healing time[ (3.31±0.68)months vs.(4.29±1.29)months ],higher AOFAS score[(89.13±2.62)vs.(79.59±4.49)](all P<0.05).The tension band group of fracture reduction quality was better than the screw group(P<0.05).The quality of fracture reduction during the operation in the tension band group was better than that in the screw group (P < 0.05).In terms of complications:no complications occurred in the screw group,one patient in the tension band group developed infection,and one patient had a loose Kirchner needle.Conclusion Precise surface positioning method in percutaneous screw fixation for Jones fracture is a safe and effective method with precise positioning,simple operation,small trauma,and rapid rehabilitation,which is worthy of clinical promotion,but the indications need to be strictly controlled according to the type of fracture.

Key words: Jones fracture, minimally invasive, screw, surface positioning, tension band

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