切开复位内固定治疗伴跖跗关节脱位的Lisfranc损伤  

Open reduction internal fixation for Lisfranc injuries combined with the tarsometatarsal joints dislocation

作　　者：王铁涛[1] 靳文阔 黄军峰 杨乐 黄立[1] 苟波[1] 古旸 WANG Tie-tao;JIN Wen-kuo;HUANG Jun-feng;YANG Le;HUANG Li;GOU Bo;GU Yang(Dept of Hand and Foot Microscopic Orthopaedics,the TCM Hospital of Baoji City,Baoji,Shaanxi 721000,China)

机构地区：[1]宝鸡市中医医院手足显微骨科,陕西宝鸡721000

出　　处：《临床骨科杂志》2020年第5期753-755,共3页Journal of Clinical Orthopaedics

摘　　要：目的探讨切开复位内固定治疗伴跖跗关节脱位的Lisfranc损伤的疗效。方法对21例伴跖跗关节脱位的闭合Lisfranc损伤患者采用切开复位内固定治疗。记录并发症情况。末次随访时采用AOFAS中足评分和疼痛VAS评分评价临床疗效。结果患者均获得随访,时间15~27个月。2例发生内固定物断裂,行内固定取出术;3例影像学有创伤性关节炎表现,其中1例发生有症状的创伤性关节炎,予二期关节融合术后恢复满意。末次随访时,AOFAS中足评分74~90(82.6±7.3)分,VAS评分0~4(2.9±0.6)分。结论对于伴跖跗关节脱位的Lisfranc损伤,一期行跖跗关节切开复位内固定治疗,疗效满意,关节炎发生率低。Objective To evaluate the therapeutic effects of open reduction and internal fixation for treatment of Lisfranc injuries combined with the tarsometatarsal joints dislocation.Methods The 21 patients with Lisfranc injuries combined with the tarsometatarsal joints dislocation were adopted open reduction and internal fixation.Postoperative complications were recorded,and the therapeutic effect was assessed with AOFAS midfoot score and visual analogue scale(VAS)at the final follow-up.Results All patients were followed up for 15~27 months.Internal fixation fracture occurred in 2 cases,who underwent internal fixation removal surgery;3 cases had radiographic evidence of traumatic osteoarthritis,but only 1 case of them had symptomatic traumatic osteoarthritis,who restored satisfactorily afterⅡ-stage arthrodesis.At the last follow-up,the AOFAS midfoot score was 74~90(82.6±7.3)points,VAS was 0~4(2.9±0.6)points.Conclusions One-stage open reduction internal fixation for Lisfranc injuries combined with the tarsometatarsal joints dislocation can achieve satisfied short-term clinical outcomes,the incidence rate of symptomatic tarsometatarsal osteoarthritis is low.

关 键 词：切开复位 内固定 LISFRANC损伤 

分 类 号：R683.42[医药卫生—骨科学] R684.7[医药卫生—外科学]