Comparative study of suture anchor and Kirschner wire tension band internal fixation for the treatment of Fifth humeral base fracture

doi:10.3877/cma.j.issn.2096-0263.2019.05.002

Abstract

Abstract:

Objective

Comparison of suture anchor and Kirschner wire tension band internal fixation for the treatment of Fifth humeral base fracture.

Methods

Retrospective analysis of 33 patients with a fifth tibiofibular basal fracture in Lawrence-I were underwent treatment and complete follow-up from June 2013 to October 2018 according to the way of internal fixation, patients were divided into suture anchor group (15 cases) and Kirschner wire tension band group (18 cases). The intraoperative time, fracture reduction satisfaction, injury healing time and postoperative functional excellence rate were recorded and compared between two groups.

Results

There was no difference in the degree of fracture reduction, healing time, and postoperative complications between the suture anchor group and the Kirschner wire tension band group, The difference between the operation time of two groups was statistically significant (t=-8.714, P<0.05). The length of the surgical incision was statistically significant (t=-13.867, P<0.05). Comparison of intraoperative perspectives is statistically significant(t=-6.834, P<0.05). At the last follow-up, according to the forefoot function score of the American Foot and Ankle Association (AOFAS), the difference in functional recovery between the two groups was statistically significant (t=4.948, P<0.05).

Conclusion

Suture anchor is simple, minimally invasive, effective and no need to take internal fixation. Compared with Kirschner wire tension band, the operation time is reduced, the length of the surgical incision is shortened, and the number of fluoroscopy is reduced. It is an effective method for the treatment of the fifth metatarsal humeral fracture.

Key words: Metatarsal Bones, fracture, Bone, Suture anchors, Bone Wires, Treatment Outcome

zhaoguang Zuo, wenbo Zeng, guodong Wang, xianhua Cai, ximing Liu. Comparative study of suture anchor and Kirschner wire tension band internal fixation for the treatment of Fifth humeral base fracture[J]. Chinese Journal of Geriatric Orthopaedics and Rehabilitation(Electronic Edition), 2019, 05(05): 250-254.

/ / Recommend

Add to citation manager EndNote|Ris|BibTeX

URL: https://zhlngkykfdzzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.2096-0263.2019.05.002

https://zhlngkykfdzzz.cma-cmc.com.cn/EN/Y2019/V05/I05/250

Figures/Tables 3

References 17

[1]	Shereff MJ. Fractures of the forefoot [J]. Instr Course Lect, 1990, 39: 133-140.
[2]	徐海林,徐人杰,王静,等.踝关节骨折的手术治疗[J].浙江临床医学, 2005, 7(10): 1082.
[3]	Devries JG,Taefi E,Bussewitz BW, et al. The fifth metatarsal base: anatomic evaluation regarding fracture mechanism and treatment algorithms [J]. J Foot Ankle Surg, 2015, 54(1): 94-98.
[4]	Fleischer AE,Stack R,Klein EE, et al. Forefoot adduction is a risk factor for jones fracture [J]. J Foot Ankle Surg, 2017, 56(5): 917-921.
[5]	Ekrol I,Court-Brown CM. Fractures of the base of the 5th metatarsal [J]. The Foot, 2004, 14(2): 96-98.
[6]	Lawrence SJ,Botte MJ. Jones' fractures and related fractures of the proximal fifth metatarsal [J]. Foot Ankle, 1993, 14(6): 358-365.
[7]	Wang X,Zhang C,Wang C, et al. Accurate determination of screw position in treating fifth metatarsal base fractures to shorten radiation exposure time [J]. Singapore Med J, 2016, 57(11): 619-623.
[8]	Wang X,Deng Y,Yu L, et al. Comparison of hollow compression screws and absorbable screws for the treatment of the fifth metatarsal fracture:Ankle function and fracture displacement [J]. J Tissue Eng, 2015, 3(1): 53-54.
[9]	Niki H,Aoki H,Inokuchi S, et al. Development and reliability of a standard rating system for outcome measurement of foot and ankle disorders I: development of standard rating system [J]. J Orthop Sci, 2005, 10(5): 457-465.
[10]	Polzer H,Polzer S,Mutschler W, et al. Acute fractures to the proximal fifth metatarsal bone: development of classification and treatment recommendations based on the current evidence [J]. Injury, 2012, 43(10): 1626-1632.
[11]	Gasse N,Luth T,Loisel F, et al. Fixation of split anterior tibialis tendon transfer by Anchorage to the base of the 5th metatarsal bone [J].Orthop Traumatol Surg Res, 2012, 98(7): 829-833.
[12]	Egol K,Walsh M,Rosenblatt K, et al. Avulsion fractures of the fifth metatarsal base: A prospective outcome study [J]. Foot Ankle Int, 2007, 28(5): 581-583.
[13]	Wu G B,Li B,Yang Y F. Comparative study of surgical and conservative treatments for fifth metatarsal base avulsion fractures (type I) in young adults or athletes[J]. J Orthop Surg(Hong Kong), 2017, 26(1): 2309499017747128.
[14]	Lutsky K F,Edelman D,Leinberry C, et al. A Prospective Evaluation of Complications after Use of Exposed Pins in the Hand and Wrist[J]. Plast Reconstr Surg, 2019, 144(3): 659-664.
[15]	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[J].中华创伤杂志, 2010, 26(12): 1090-1092.
[16]	Hong CC,Nag K,Yeow H, et al. Suture anchor fixation for fifth metatarsal tuberosity avulsion fractures: a case series and review of literature [J]. J Foot Ankle Surg, 2018, 57(5): 1030-1033.
[17]	时亮,段亮,董向辉.早期负重治疗第五跖骨基底部骨折[J].临床骨科杂志, 2019, 22(01): 50.

分组	例数	年龄（岁，±s）	性别（例）		受伤至治疗时间（d，±s）	骨折原因（例）		Ekrol分型
分组	例数	年龄（岁，±s）	男	女	受伤至治疗时间（d，±s）	扭伤	砸伤	1型	2型	3型
缝合锚	15	35.4±7.3	10	5	5.7±1.2	9	6	3	6	6
张力带	18	38.2±11.2	12	6	5.6±1.1	14	4	4	5	9
t/χ²值		-0.821	0.001		0.303	0.527		0.151	-0.751	0.561
P值		0.418	0.998		0.764	0.468		0.881	0.474	0.580

分组	例数	年龄（岁，±s）	性别（例）		受伤至治疗时间（d，±s）	骨折原因（例）		Ekrol分型
分组	例数	年龄（岁，±s）	男	女	受伤至治疗时间（d，±s）	扭伤	砸伤	1型	2型	3型
缝合锚	15	35.4±7.3	10	5	5.7±1.2	9	6	3	6	6
张力带	18	38.2±11.2	12	6	5.6±1.1	14	4	4	5	9
t/χ²值		-0.821	0.001		0.303	0.527		0.151	-0.751	0.561
P值		0.418	0.998		0.764	0.468		0.881	0.474	0.580

分组	例数	手术时间（min,±s）	复位满意度[例(%)]		功能评分（分，±s）
分组	例数	手术时间（min,±s）	优/良	差	功能评分（分，±s）
缝合锚	15	24.4±3.5	15(100)	0(0)	95.3±1.5
张力带	18	35.6±3.8	16(88.9)	2(11.1)	90.2±3.7
t值/χ²		-8.714	0.359		4.948
P值		0.000	0.549		0.000

分组	例数	手术时间（min,±s）	复位满意度[例(%)]		功能评分（分，±s）
分组	例数	手术时间（min,±s）	优/良	差	功能评分（分，±s）
缝合锚	15	24.4±3.5	15(100)	0(0)	95.3±1.5
张力带	18	35.6±3.8	16(88.9)	2(11.1)	90.2±3.7
t值/χ²		-8.714	0.359		4.948
P值		0.000	0.549		0.000

分组	例数	切口长度（cm，±s）	术中透视次数（±s）	术后并发症[例(%)]
缝合锚	15	2.0±0.3	4.3±1.0	0(0)
张力带	18	3.6±0.4	8.9±1.6	3(16.7)
t值/χ²		-13.867	-9.966	-1.844
P值		0.000	0.000	0.083

Please choose a citation manager

Content to export