微型钛板跨关节固定结合埋头钉治疗Lisfranc损伤  

Treatment of Lisfranc injuries with across⁃joint miniplate and headless screw

作　　者：尹建[1] 崔勇[1] 韩正锋[1] 王秋实 王宇初 YIN Jian;CUI Yong;HAN Zheng-feng;WANG Qiu-shi;WANG Yu-chu(Department of Hand and Foot Surgery,Beijing Chuiyangliu Hospital,Beijing 100022,China)

机构地区：[1]北京市垂杨柳医院手足外科,北京100022

出　　处：《骨科》2020年第5期376-381,共6页ORTHOPAEDICS

摘　　要：目的观察应用微型钛板结合埋头钉治疗Lisfranc损伤的临床疗效。方法回顾性分析我院2016年8月至2018年7月收治的13例Lisfranc损伤病人的临床资料。其中男9例,女4例,平均年龄为49.2岁(35~69岁),受伤至手术时间平均为11.5 d(6~22 d)。所有病人经术前准备完善,局部软组织条件改善后行切开复位内固定术。采用美国足踝医师协会(American Orthopedic Foot and Ankle Society,AOFAS)踝与后足功能评分系统及疼痛视觉模拟量表(visual analogue scale,VAS)评估治疗效果,同时观察并发症情况。结果本组病人平均随访19.8个月(13~37个月)。术后3个月X线片显示骨折端均愈合,未出现再次脱位。末次随访时AOFAS评分为(86.5±6.1)分,VAS评分为(2.0±1.4)分,有1例病人出现伤口感染,1例病人取出内固定时发现有螺钉断裂。结论微型钛板结合埋头钉治疗Lisfranc损伤固定效果可靠,有利于解剖复位,临床疗效满意。Objective To observe the effect of miniplate and headless screw in treatment of Lisfranc injury.Methods Thirteen patients with Lisfranc injury from August 2016 to July 2018 were included in this retrospective study.There were 9 males and 4 females with an average age of 49.2 years(35⁃69 years).The duration from injury to surgery was 11.5 d(6⁃22 d).All patients were treated by open reduction and internal fixation after full preoperative preparation and soft tissue condition improved.Ankle⁃Midfoot Scale made by American Orthopedic Foot and Ankle Society(AOFAS)and visual analogue scale(VAS)were used to assess patients'􀆳postoperative foot function.The complications were also followed up.Results All patients were followed up for 13⁃37 months,with an average of 19.8 months.The fracture union time after surgery was 3 months,and no re⁃dislocation occurred.At the last follow up,the mean AOFAS score was 86.5±6.1,and the VAS score was 2.0±1.4.There was one case of wound infection,and one case of broken screw when the internal fixation was removed.Conclusion The open reduction and internal fixation with miniplate and headless screw can achieve anatomical reduction,and the clinical outcome is satisfactory.

关 键 词：LISFRANC损伤 切开复位 内固定 

分 类 号：R687.4[医药卫生—骨科学]