无头加压空心螺钉与普通空心螺钉治疗跖跗关节复合体损伤的疗效比较

摘要

Objective To explore the clinical effect of headless compression screws and conventional hollow screws for treating tarsometatarsal joint complex injury.Methods A total of 31 patients of tarsometatarsal joint com-plex injury treated in No.215 Hospital of Shaanxi Nuclear Industry from July 2011 to May 2016 were chosen.The pa-tients were divided into the observation group(n=14,headless compression screws)and the control group(n=17,conven-tional hollow screws)according to the kind of internal fixation they received.The foot function was evaluated according to American Orthopaedic Foot and Ankle Society(AOFAS)within the postoperative first year.The weight bearing time, the fracture healing time,the complication rate,and the treatment cost of two groups were also comparatively analyzed. Results The operation time,AOFAS scores and complication rates showed no statistically significant difference be-tween the observation group and the control group(P>0.05).The fracture healing time and the weight bearing time were(12.7±1.4)d and(13.3±2.0)d in the observation group,versus(14.0±2.1)d and(14.3±2.4)d in the control group(P>0.05). In terms of treatment cost,the average price of screws in the observation group was significantly higher than that of the control group,(3 162.9±1033.3)yuan vs(1 057.1±244.0)yuan,P<0.05.Conclusion For the treatment of tarsometatarsal joint complex injury,headless compression screws and conventional hollow screws are all ideal consumables of internal fixations,but for patients with poor economic conditions,the headless compression screws should be chosen carefully.%目的 探讨无头加压空心螺钉和普通空心螺钉在治疗跖跗关节复合体(TJC)损伤方面的临床应用效果.方法 回顾性分析2011年7月至2016年5月在陕西省核工业二一五医院手术治疗的31例TJC损伤患者的临床资料,根据内固定种类的不同将其分为使用无头加压空心螺钉的观察组(n=14)和使用普通空心螺钉的对照组(n=17),以术后1年作为时间节点,采用美国足踝外科协会(AOFAS)评分系统对足部功能进行评价,比较两组患者下地负重时间、骨折愈合时间、并发症发生率及螺钉价格.结果 两组患者的手术时间、AOFAS评分和并发症发生率比较差异均无统计学意义(P>0.05);观察组患者的骨折愈合时间和下地负重时间分别为(12.7±1.4)d、(13.3±2.0)d,虽略优于对照组的(14.0±2.1)d、(14.3±2.4)d,但组间比较差异均无统计学意义(P>0.05);观察组患者的螺钉价格为(3162.9±1033.3)元,明显高于对照组的(1057.1±244.0)元,差异具有统计学意义(P<0.05).结论 无头加压空心螺钉和普通空心螺钉均为治疗TJC损伤的理想内固定耗材种类,但对个人经济条件欠佳者,建议谨慎选择无头加压空心螺钉治疗.