跖跗关节损伤的手术治疗  

Surgical Treatment of Tarsometatarsal Joint Injury

作　　者：倪善军[1] 徐卫袁[1] 孙俊英[2] 谷遐龄[1] 沙卫平[1] 陆怀明[1] 

机构地区：[1]江苏省张家港市第一人民医院,江苏张家港215600 [2]苏州大学附属第一人民医院,江苏苏州215006

出　　处：《实用骨科杂志》2005年第2期148-150,共3页Journal of Practical Orthopaedics

摘　　要：目的　探讨跖跗关节损伤的手术治疗及其疗效。方法　对4 6例跖跗关节损伤患者分别用闭合复位石膏外固定(2例)、闭合复位克氏针内固定加石膏外固定(18例)、开放复位螺丝钉内固定加石膏外固定(2 6例)进行治疗,对其临床疗效进行评价。结果　术后平均随访2 .5 a,手术治疗者优良率达86 .3%。8例发生创伤性关节炎,均为未达解剖复位者,其中单纯石膏固定2例,克氏针固定3例,螺丝钉固定3例。7例单纯脱位者中5例发生创伤性关节炎。结论　手术治疗效果与骨折脱位的复位情况相关,创伤本身也是影响疗效的重要因素。Objective To research the surgical treatment and its result of the injury of tarsometatarsal joints. Methods 46 patients with tarsometatarsal joint injuries were treated 3 different. Methods close reduction cast fixation(2 cases), close reduction and internal fixation with Kirstchner wires plus cast fixation(18 cases), open reduction and internal fixation with cortical screws plus cast fixation(26 cases). Evaluate the clinical results after treatment. Results All patients were followed up for average 2.5 years. The rate of good and excellent results is 86.3%. 8 patients had post-traumatic arthritis, in which 2 cases were in cast fixation group, 3 cases were in Kirstchner wire fixation group, 3 cases were in cortical screw fixation group. They all didn′t get anatomic reduction. In 7 cases with pure dislocation 5 had post-traumatic arthritis. Conclusion The clinical result of surgical treatment in directly related to reduction. And trauma itself is also a significant factor that affect the result besides reduction.

关 键 词：跖跗关节损伤 手术治疗 闭合复位石膏外固定 创伤性关节炎 克氏针内固定 螺丝钉内固定 克氏针固定 螺丝钉固定 开放复位 临床疗效 解剖复位 石膏固定 骨折脱位 治疗效果 伤患者 优良率 治疗者 单纯 

分 类 号：R684[医药卫生—骨科学] R683.41[医药卫生—外科学]