手术-jones骨折(第5跖骨基底骨折)切开复位内固定术.docx

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1、Jonesmann骨折指第五跖干骺端与骨干连接部骨折。英国骨科医生Sir Robert Jones（1857–1933）自己跳舞后发生此类骨折并首先描述，故此得名。Jonesfracturesoccurinasmallareaofthefifthmetatarsalthat receiveslessblood andisthereforemorepronetodifficultiesinhealing.AJonesfracturecanbeeitherastressfracture(atinyhairlinebreakthatoccursovertime)oranacute(sudden)br

2、eak.Jonesfracturesarecausedbyoveruse,repetitivestress,ortrauma.Theyarelesscommonandmoredifficulttotreatthanavulsionfractures.     A Jonesfracture isa fracture ofthe diaphysis ofthe fifthmetatarsal ofthe foot.Thefifthmetatarsalisatthebaseofthesmall toe.The proximalend,wheretheJonesfractureoccurs,isin

3、themidportionofthefoot.PatientswhosustainaJonesfracturehave pain overthisarea,swelling,anddifficultywalking.Thefracturewasfirstdescribedby British orthopedicsurgeonSir RobertJones,whosustainedthisinjuryhimselfwhiledancing,inthe AnnalsofSurgery in1902.       Fracturesofthefifthmetatarsalofthefootares

4、urprisinglycontroversialamongradiologists,particularlyconcerningproximalmetatarsalfractures.Sometermthesefractures Jonesfractures,others dancersfractures,whileotherssimplytermthem proximalmetatarsalfractures.AccordingtoOrthopedicRadiology(AdamGreenspan,3rdedition),a"trueJones"fractureoccursoneinchdi

5、staltothebaseofthefifthmetatarsal.Itis notduetoperoneusbrevistendonavulsionbutratheratwistinginversioninjurytothefoot.GreenspanstatesthatmoreproximalinjuriesarefrequentlymisinterpretedasJonesfracturesbutreallyareavulsionfracturesbytheperoneusbrevistendon.Theselatterfractureshealquickly,whilemoredist

6、alfracturesmayundergofibrousuniononly.Apatientsteppedoffacurbandsustainedafractureoftheproximalaspectofthefifthmetatarsal.AccordingtoGreenspan,thiswouldbetermeda"trueJonesfracture."Incontradistinction,thispatientsustainedafractureoftheproximalaspectofthefifthmetatarsal.Greenspantermsthisanavulsionin

7、jury.Inanavulsionfracture,asmallpieceofboneispulledoffthemainportionofthebonebyatendonorligament.Thistypeoffractureistheresultofaninjuryinwhichtheanklerolls.Avulsionfracturesareoftenoverlookedwhenthey