跖跗关节损伤的疗效分析  

Analysis of result of tarsometatarsal joint injuries

作　　者：栗剑[1] 王福权[2] 

机构地区：[1]北京大学首钢医院骨科,北京市石景山区100041 [2]卫生部北京医院

出　　处：《中国矫形外科杂志》2005年第14期1072-1073,共2页Orthopedic Journal of China

摘　　要：[目的]分析1984～2004年间对跖跗关节损伤采用非手术治疗和手术治疗的效果。[方法]回顾性研究20年对13名跖跗关节损伤病人采取闭合复位治疗(3例)和开放复位内固定治疗(10例)的结果。平均随访6.9年(从6个月～20年)。将治疗结果按照疼痛、功能、步态、畸形和X线片形态等进行评定,分为好、中、差。[结果]全部的病人均获得解剖复位。在随访取出内固定物和拆除管型石膏的病人中没有发现再脱位,未见纵弓塌陷。13例均获得较好的结果。[结论]跖跗关节损伤获得成功疗效的关键是早期准确的诊断,及时的解剖复位和稳定的固定。稳定的,无移位的损伤可以通过管型石膏制动,保护下承重治疗。不稳定的骨折脱位需要开放复位内固定治疗。[Objective] The purpose of this study is to analyze the result of non-operative treatment and operative treatment for tarsometatarsal joint injuries performed from 1984 to 2004. [Method] A total of 13 patients with Lisfranc injuries have received closed reduction( in 3 cases) or open reduction and internal fixation ( in 10 cases) treatment. The patients were then followed up for an averaged 81 months ( ranged 6~242 months). The result was classified as being good, fair or poor on the basis of residual pain, function, gait, deformity and radiological features. [Result] Anatomical reduction was achieved in all cases. None of the cases showed loss of reduction after the implantations and casts were removed. No longitudinal arch collapse was seen. All patients gained good functional outcomes. [Conclusion] In the treatment of fracture/dislocation of the tarsometatarsal joint, optimal result will be achieved by accurate diagnosis, prompt anatomical reduction and stable fixation. Stable, non-displaced injuries can be treated by cast immobilization and protected weight bearing. Unstable injuries require open reductions and internal fixations.

关 键 词：跖跗关节损伤 疗效分析 内固定治疗 闭合复位治疗 开放复位 解剖复位 非手术治疗 2004年 回顾性研究 损伤病人 治疗结果 管型石膏 内固定物 石膏制动 骨折脱位 X线片 再脱位 无移位 不稳定 随访 

分 类 号：R684[医药卫生—骨科学] R683.42[医药卫生—外科学]