Effectiveness of transverse double “8”-shaped tension band technique for Lawrence zone<b>Ⅰ</b> fracture of the fifth metatarsal base_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

JIANG Hongtao , XUE Xinxin , WANG Jingna , GAO Yunfeng ,  LI Xiaodong , JIANG Hongtao , XUE Xinxin , WANG Jingna , GAO Yunfeng ,  LI Xiaodong

Department of Hand and Foot Surgery, Affiliated Hospital of Chengde Medical College, Chengde Hebei, 067000, P. R. China;

Corresponding?author：

LI Xiaodong, Email: 15097824763@163.com; LI Xiaodong, Email: 15097824763@163.com

Keywords：

The 5th metatarsal base fracture; Lawrence zone Ⅰ fracture; tension band technique; internal fixation

DOI：

10.7507/1002-1892.202401049

Video：

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Objective To explore the effectiveness of transverse double “8”-shaped tension band technique in the treatment of Lawrence zoneⅠfracture of the 5th metatarsal base. Methods Between February 2019 and October 2021, 15 patients with Lawrence zoneⅠfracture of the 5th metatarsal base were treated with transverse double “8”-shaped tension band technique. There were 8 males and 7 females, with a median age of 40 years (range, 23-59 years). The fractures were caused by sprains. The time from injury to operation was 3-7 days (mean, 4.1 days). X-ray films were taken to observe the fracture healing and the anchor looseness and detachment. The foot function was evaluated by American Orthopaedic Foot and Ankle Society (AOFAS) score, visual analogue scale (VAS) score, and the eversion angle of the calcaneal talus joint. Results The incisions healed by first intention after operation in 14 cases and the incision healed poorly in 1 case. All patients were followed up 8-12 months (median, 10 months). The imaging examination showed that all fractures healed well, with a healing time of 10-14 weeks (mean, 11.7 weeks). At last follow-up, AOFAS score was 82-100 (median, 98); 13 cases were excellent and 2 cases were good, with an excellent and good rate of 100%. VAS score was 0-3 (median, 1). Three cases had mild limited ankle joint range of motion, while 12 cases had normal range of motion. The eversion angle of the calcaneal talus joint was 25°-32° (median, 30°). Conclusion The application of transverse double “8”-shaped tension band technique for Lawrence zone Ⅰ fracture of the 5th metatarsal base has advantages such as simple operation, avoidance of secondary operation, and reduction of foreign body sensation, with definite effectiveness.

Citation： JIANG Hongtao, XUE Xinxin, WANG Jingna, GAO Yunfeng, LI Xiaodong. Effectiveness of transverse double “8”-shaped tension band technique for Lawrence zoneⅠ fracture of the fifth metatarsal base. Chinese Journal of Reparative and Reconstructive Surgery, 2024, 38(4): 444-447. doi: 10.7507/1002-1892.202401049 Copy

1.	Lawrence SJ, Botte MJ. Jones’ fractures and related fractures of the proximal fifth metatarsal. Foot Ankle, 1993, 14(6): 358-365.
2.	Lawrence SJ, Botte MJ. Jones’ fractures and related fractures of the proximal fifth metatarsal. Foot Ankle, 1993, 14(6): 358-365.
3.	和文寶, 張英琪, 楊云峰, 等. 第五跖骨基底部撕脫性骨折的骨折線分布特點. 中華創傷雜志, 2021, 37(4): 352-355.
4.	和文寶, 張英琪, 楊云峰, 等. 第五跖骨基底部撕脫性骨折的骨折線分布特點. 中華創傷雜志, 2021, 37(4): 352-355.
5.	Soheil Ashkani-Esfahani, Alexandra Flaherty, Bardiya Akhbari, et al. The incidence of and demographic disparities among fifth metatarsal fracture nonunions. Journal of Foot and Ankle Surgery (Asia Pacific), 2023, 10(1): 204-208.
6.	Soheil Ashkani-Esfahani, Alexandra Flaherty, Bardiya Akhbari, et al. The incidence of and demographic disparities among fifth metatarsal fracture nonunions. Journal of Foot and Ankle Surgery (Asia Pacific), 2023, 10(1): 204-208.
7.	曹清, 王貴忻, 田旭. 急性第五跖骨近端骨折的治療現狀. 中國矯形外科雜志, 2022, 30(11): 998-1001.
8.	曹清, 王貴忻, 田旭. 急性第五跖骨近端骨折的治療現狀. 中國矯形外科雜志, 2022, 30(11): 998-1001.
9.	黃培鎮, 黃學員, 董航, 等. 克氏針錨釘張力帶治療第五跖骨基底部粉碎性撕脫骨折. 中國修復重建外科雜志, 2015, 29(6): 785-786.
10.	黃培鎮, 黃學員, 董航, 等. 克氏針錨釘張力帶治療第五跖骨基底部粉碎性撕脫骨折. 中國修復重建外科雜志, 2015, 29(6): 785-786.
11.	楊峰, 張濤, 楊立春. 顱腦損傷合并下肢骨折患者血清胰島素樣生長因子、生長激素、骨形態發生蛋白表達的實驗研究. 中國傷殘醫學, 2020, 28(7): 52-54.
12.	楊峰, 張濤, 楊立春. 顱腦損傷合并下肢骨折患者血清胰島素樣生長因子、生長激素、骨形態發生蛋白表達的實驗研究. 中國傷殘醫學, 2020, 28(7): 52-54.
13.	Akimau PI, Cawthron KL, Dakin WM, et al. Symptomatic treatment or cast immobilisation for avulsion fractures of the base of the fifth metatarsal: a prospective, randomised, single-blinded non-inferiority controlled trial. Bone Joint J, 2016, 98-B(6): 806-811.
14.	Akimau PI, Cawthron KL, Dakin WM, et al. Symptomatic treatment or cast immobilisation for avulsion fractures of the base of the fifth metatarsal: a prospective, randomised, single-blinded non-inferiority controlled trial. Bone Joint J, 2016, 98-B(6): 806-811.
15.	李建鵬, 王松, 高翔, 等. 靜態騎縫釘固定治療外側跖骨頸骨折的臨床療效. 中華外科雜志, 2020, 58(9): 713-717.
16.	李建鵬, 王松, 高翔, 等. 靜態騎縫釘固定治療外側跖骨頸骨折的臨床療效. 中華外科雜志, 2020, 58(9): 713-717.
17.	霍倫, 羅鵬. 早期負重及晚期負重對第五跖骨基底部骨折臨床療效的影響. 骨科, 2020, 11(6): 565-568.
18.	霍倫, 羅鵬. 早期負重及晚期負重對第五跖骨基底部骨折臨床療效的影響. 骨科, 2020, 11(6): 565-568.
19.	邱福平, 王志鋼, 韋小見, 等. 鎖定鋼板聯合鈦纜內固定治療VancouverB1型股骨假體周圍骨折. 中國矯形外科雜志, 2022, 30(14): 1339-1341.
20.	邱福平, 王志鋼, 韋小見, 等. 鎖定鋼板聯合鈦纜內固定治療VancouverB1型股骨假體周圍骨折. 中國矯形外科雜志, 2022, 30(14): 1339-1341.
21.	趙家立, 孫強, 蘇云, 等. 帶孔金屬骨針鈦纜張力帶與克氏針鋼絲張力帶治療內踝骨折療效比較. 臨床骨科雜志, 2018, 21(3): 350-353.
22.	趙家立, 孫強, 蘇云, 等. 帶孔金屬骨針鈦纜張力帶與克氏針鋼絲張力帶治療內踝骨折療效比較. 臨床骨科雜志, 2018, 21(3): 350-353.
23.	張磊, 王浩軍, 肖繼龍, 等. 帶線錨釘縫合固定術治療第五跖骨基底部Ⅰ區骨折的療效觀察. 生物骨科材料與臨床研究, 2020, 17(1): 60-62,66.
24.	張磊, 王浩軍, 肖繼龍, 等. 帶線錨釘縫合固定術治療第五跖骨基底部Ⅰ區骨折的療效觀察. 生物骨科材料與臨床研究, 2020, 17(1): 60-62,66.
25.	鄧志航, 黃海波, 魯新濤. 血清堿性磷酸酶活性和鈣磷乘積與非感染性四肢長骨骨折愈合的相關性研究. 醫師在線, 2023, 13(5): 6-8.
26.	鄧志航, 黃海波, 魯新濤. 血清堿性磷酸酶活性和鈣磷乘積與非感染性四肢長骨骨折愈合的相關性研究. 醫師在線, 2023, 13(5): 6-8.
27.	安志輝, 邢燕鋒, 何娟, 等. 鈦鋼板內固定、克氏針內固定治療SandersⅡ、Ⅲ型跟骨骨折的療效比較. 創傷外科雜志, 2022, 24(8): 610-612.
28.	安志輝, 邢燕鋒, 何娟, 等. 鈦鋼板內固定、克氏針內固定治療SandersⅡ、Ⅲ型跟骨骨折的療效比較. 創傷外科雜志, 2022, 24(8): 610-612.

1. Lawrence SJ, Botte MJ. Jones’ fractures and related fractures of the proximal fifth metatarsal. Foot Ankle, 1993, 14(6): 358-365.
2. Lawrence SJ, Botte MJ. Jones’ fractures and related fractures of the proximal fifth metatarsal. Foot Ankle, 1993, 14(6): 358-365.
3. 和文寶, 張英琪, 楊云峰, 等. 第五跖骨基底部撕脫性骨折的骨折線分布特點. 中華創傷雜志, 2021, 37(4): 352-355.
4. 和文寶, 張英琪, 楊云峰, 等. 第五跖骨基底部撕脫性骨折的骨折線分布特點. 中華創傷雜志, 2021, 37(4): 352-355.
5. Soheil Ashkani-Esfahani, Alexandra Flaherty, Bardiya Akhbari, et al. The incidence of and demographic disparities among fifth metatarsal fracture nonunions. Journal of Foot and Ankle Surgery (Asia Pacific), 2023, 10(1): 204-208.
6. Soheil Ashkani-Esfahani, Alexandra Flaherty, Bardiya Akhbari, et al. The incidence of and demographic disparities among fifth metatarsal fracture nonunions. Journal of Foot and Ankle Surgery (Asia Pacific), 2023, 10(1): 204-208.
7. 曹清, 王貴忻, 田旭. 急性第五跖骨近端骨折的治療現狀. 中國矯形外科雜志, 2022, 30(11): 998-1001.
8. 曹清, 王貴忻, 田旭. 急性第五跖骨近端骨折的治療現狀. 中國矯形外科雜志, 2022, 30(11): 998-1001.
9. 黃培鎮, 黃學員, 董航, 等. 克氏針錨釘張力帶治療第五跖骨基底部粉碎性撕脫骨折. 中國修復重建外科雜志, 2015, 29(6): 785-786.
10. 黃培鎮, 黃學員, 董航, 等. 克氏針錨釘張力帶治療第五跖骨基底部粉碎性撕脫骨折. 中國修復重建外科雜志, 2015, 29(6): 785-786.
11. 楊峰, 張濤, 楊立春. 顱腦損傷合并下肢骨折患者血清胰島素樣生長因子、生長激素、骨形態發生蛋白表達的實驗研究. 中國傷殘醫學, 2020, 28(7): 52-54.
12. 楊峰, 張濤, 楊立春. 顱腦損傷合并下肢骨折患者血清胰島素樣生長因子、生長激素、骨形態發生蛋白表達的實驗研究. 中國傷殘醫學, 2020, 28(7): 52-54.
13. Akimau PI, Cawthron KL, Dakin WM, et al. Symptomatic treatment or cast immobilisation for avulsion fractures of the base of the fifth metatarsal: a prospective, randomised, single-blinded non-inferiority controlled trial. Bone Joint J, 2016, 98-B(6): 806-811.
14. Akimau PI, Cawthron KL, Dakin WM, et al. Symptomatic treatment or cast immobilisation for avulsion fractures of the base of the fifth metatarsal: a prospective, randomised, single-blinded non-inferiority controlled trial. Bone Joint J, 2016, 98-B(6): 806-811.
15. 李建鵬, 王松, 高翔, 等. 靜態騎縫釘固定治療外側跖骨頸骨折的臨床療效. 中華外科雜志, 2020, 58(9): 713-717.
16. 李建鵬, 王松, 高翔, 等. 靜態騎縫釘固定治療外側跖骨頸骨折的臨床療效. 中華外科雜志, 2020, 58(9): 713-717.
17. 霍倫, 羅鵬. 早期負重及晚期負重對第五跖骨基底部骨折臨床療效的影響. 骨科, 2020, 11(6): 565-568.
18. 霍倫, 羅鵬. 早期負重及晚期負重對第五跖骨基底部骨折臨床療效的影響. 骨科, 2020, 11(6): 565-568.
19. 邱福平, 王志鋼, 韋小見, 等. 鎖定鋼板聯合鈦纜內固定治療VancouverB1型股骨假體周圍骨折. 中國矯形外科雜志, 2022, 30(14): 1339-1341.
20. 邱福平, 王志鋼, 韋小見, 等. 鎖定鋼板聯合鈦纜內固定治療VancouverB1型股骨假體周圍骨折. 中國矯形外科雜志, 2022, 30(14): 1339-1341.
21. 趙家立, 孫強, 蘇云, 等. 帶孔金屬骨針鈦纜張力帶與克氏針鋼絲張力帶治療內踝骨折療效比較. 臨床骨科雜志, 2018, 21(3): 350-353.
22. 趙家立, 孫強, 蘇云, 等. 帶孔金屬骨針鈦纜張力帶與克氏針鋼絲張力帶治療內踝骨折療效比較. 臨床骨科雜志, 2018, 21(3): 350-353.
23. 張磊, 王浩軍, 肖繼龍, 等. 帶線錨釘縫合固定術治療第五跖骨基底部Ⅰ區骨折的療效觀察. 生物骨科材料與臨床研究, 2020, 17(1): 60-62,66.
24. 張磊, 王浩軍, 肖繼龍, 等. 帶線錨釘縫合固定術治療第五跖骨基底部Ⅰ區骨折的療效觀察. 生物骨科材料與臨床研究, 2020, 17(1): 60-62,66.
25. 鄧志航, 黃海波, 魯新濤. 血清堿性磷酸酶活性和鈣磷乘積與非感染性四肢長骨骨折愈合的相關性研究. 醫師在線, 2023, 13(5): 6-8.
26. 鄧志航, 黃海波, 魯新濤. 血清堿性磷酸酶活性和鈣磷乘積與非感染性四肢長骨骨折愈合的相關性研究. 醫師在線, 2023, 13(5): 6-8.
27. 安志輝, 邢燕鋒, 何娟, 等. 鈦鋼板內固定、克氏針內固定治療SandersⅡ、Ⅲ型跟骨骨折的療效比較. 創傷外科雜志, 2022, 24(8): 610-612.
28. 安志輝, 邢燕鋒, 何娟, 等. 鈦鋼板內固定、克氏針內固定治療SandersⅡ、Ⅲ型跟骨骨折的療效比較. 創傷外科雜志, 2022, 24(8): 610-612.

Chinese Journal of Reparative and Reconstructive Surgery

Effectiveness of transverse double “8”-shaped tension band technique for Lawrence zoneⅠ fracture of the fifth metatarsal base

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