THE INTRAOSSEOUS BLOOD-SUPPLY OF THE 5TH METATARSAL - IMPLICATIONS FOR PROXIMAL FRACTURE-HEALING
THE INTRAOSSEOUS BLOOD-SUPPLY OF THE 5TH METATARSAL - IMPLICATIONS FOR PROXIMAL FRACTURE-HEALING
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DOI：
10.1177/107110079201300306
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发表时间：
1992-03-01
期刊：
影响因子：
--
通讯作者：
HERSH, A
中科院分区：
文献类型：
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作者：
SMITH, JW;ARNOCZKY, SP;HERSH, A
根据解剖位置和临床病程，第五跖骨近端骨折可分为两个不同的组。结节骨折通常通过非手术治疗愈合良好，而发生在骨干近端(距结节远端1.5厘米)的骨折会显著增加延迟愈合或不愈合的风险。本文对10具新鲜冷冻截肢或身体标本进行了动脉注射印度墨汁或硫酸钡混悬液的研究，旨在描述第5跖骨的骨内血管解剖及其对颅底骨折愈合的临床意义。第5跖骨粗隆的骨内血供来自大量干骺端血管，以随机、放射状的方式穿透粗隆的非关节表面。骨干近端的血供主要来自滋养动脉，滋养动脉产生髓内纵支。粗隆的动脉在粗隆的远端与骨干近端的血供汇合，对应骨折愈合预后较差的区域。这表明近端骨干骨折后相对缺乏血液供应可能是延迟愈合和不愈合的原因之一。
Fractures of the proximal fifth metatarsal can be divided into two distinct groups based on anatomical location and clinical course. Fractures of the tuberosity often heal well with nonoperative treatment, whereas fractures occurring in the proximal diaphysis (up to 1.5 cm distal to the tuberosity) have significantly increased risk for delayed union or nonunion. It is the purpose of this paper to describe the intraosseous vascular anatomy of the fifth metatarsal, and the clinical implications for basilar fracture healing.Ten fresh-frozen amputation or cadaver specimens were studied following arterial injection with India ink or barium sulfate suspension. The intraosseous blood supply to the fifth metatarsal tuberosity arosee from numerous metaphyseal vessels penetrating the nonarticular surfaces of the tuberosity in a random, radiate pattern. The blood supply to the proximal diaphysis was derived primarily from the nutrient artery, which gave rise to longitudinal intramedullary branches. The arterial supply to the tuberosity joined the supply of the proximal diaphysis in the area just distal to the tuberosity, corresponding to the region of poor prognosis for fracture healing. This suggests that a relative lack of blood supply following a proximal diaphyseal fracture may contribute to delayed union and nonunion.