微型锁定加压钢板结合克氏针内固定治疗Lisfranc关节三柱损伤  

Mini locking compression plates combined with Kirschner wire for treatment of three-column injuries of Lisfranc joint

作　　者：衣兰凯[1] 孙建民[1] 姜厚森[1] 赵世波[1] 尚小鹏[1] 

机构地区：[1]山东省潍坊市人民医院手足骨外科,山东潍坊261041

出　　处：《中国矫形外科杂志》2016年第6期491-495,共5页Orthopedic Journal of China

摘　　要：[目的]探讨切开复位微型锁定加压钢板（LCP）结合克氏针内固定治疗Lisfranc关节三柱损伤的疗效及治疗体会。[方法]自2011年6月～2014年12月本院共收治12例12足Lisfranc关节三柱损伤患者,按Myerson分类：A型8例,C2型4例,均行切开复位内固定治疗,应用微型LCP结合克氏针内固定治疗,术后观察并发症发生情况,定期放射学检查随诊,以美国足踝外科协会AOFAS评分系统和疼痛视觉模拟评分（VAS）进行功能评估。[结果]12例患者全部获得随访,随访时间12～24个月,平均18个月。术后患者均未发生切口感染、皮肤坏死、骨筋膜室综合征及内固定失效等并发症,2例于末次随访时出现骨性关节炎表现,行走疼痛,1例较轻,1例需口服止痛药物,均不影响日常生活。末次随访AOFAS总评分（83.4±8.1）分,优4例,良6例,可2例,优良率为83.3%。VSA评分为0～6分,平均（2.5±0.7）分。[结论]切开复位应用微型LCP结合克氏针内固定治疗Lisfranc关节三柱损伤,能使跖跗关节解剖复位,固定确切,术后并发症少,临床疗效满意。[ Objective] To investigate outcome of Lisfranc injuries involved three columns treated by open reduction and in- ternal fixation with mini locking compression plates （mini - LCP） and Kirschner wires. [ Method ] From June 2011 to December 2014,12 cases of Lisfranc injuries affected three columns were surgically treated in our department, of them,8 patients were type A and four were type C2 according to Myerson classification. All patients received open reduction and internal fixation using mini -LCP and Kirschner wires. Postoperatively, foot function was assessed using American Orthopaedic Foot and Ankle Society （AOFAS） Scales and Visual Analogue Scales （ VAS）, and X - ray films were taken in the regular follow - up intervals. [ Re- sult ] All the patients were followed up from 12 to 24 months,with an average of 18 months. No incision infection, skin necrosis, osteofascial compartment syndrome and internal fixation failure were observed in any patient. At the latest follow -up ,2 cases re- ported osteoarthritic pain, which did not affect their daily life. The pain was mild in one case and was alleviated with oral analge- sics in another patient. Total AOFAS score was 83.4 ＋ 8.1 in average, which graded as execellent in 4 cases, good in 6 cases, fair in 2 cases, with an execellent and good results rate of 83.3 %. In addition, VSA score ranged from 0 to 6 points with an aver- age of 2.5 ± 0.7. [ Conclusion ] Open reduction and internal fixation with mini - LCP and Kirschner wire for treatment of Lis- franc injuries has advantages of achieving anatomical reduction with stable fixation and without severe complications, can offer satisfactory clinical outcome.

关 键 词：微型锁定加压钢板 克氏针 LISFRANC关节 内固定 

分 类 号：R687.3[医药卫生—骨科学]