螺钉与钢板固定Lisfranc损伤的比较  

Comparison of screws versus plate for internal fixation of Lisfranc injury

作　　者：李立[1] 李一凡[1] 符东林[1] 董磊[1] 樊宗庆[1] 朱彬 刘晓飞 陈洪康 LI Li;LI Yi-fan;FU Dong-lin;DONG Lei;FAN Zong-qing;ZHU Bin;LIU Xiao-fei;CHEN Hong-kang(Department of Orthopedics,People's Hospital of Fuyang City,Fuyang 236000,China)

机构地区：[1]阜阳市人民医院骨科,安徽阜阳236000

出　　处：《中国矫形外科杂志》2021年第6期556-559,共4页Orthopedic Journal of China

摘　　要：[目的]比较跨关节螺钉、背侧桥接钢板或螺钉钢板联合固定治疗中足Lisfranc损伤的短期疗效。[方法]本科2017年1月~2019年10月采用开放复位内固定治疗Lisfranc损伤36例,其中,15例采用跨关节螺钉固定(螺钉组),10例采用背侧桥接钢板固定(钢板组),11例采用螺钉联合钢板固定(联合组)。以中足AOFAS功能评分、Wippula功能及影像学系统评价表分别评估三组患者术后患肢功能和复位维持情况。[结果]全部患者均顺利完成手术,术中无神经、血管损伤等严重并发症,术后三组患者全部获得随访,随访时间12~45个月,平均(26.24±10.42)个月。随时间推移,三组AOFAS评分均显著增加,不同时间点差异均有统计学意义(P<0.05),术后6、12个月及末次随访时三组间AOFAS评分的差异均无统计学意义(P>0.05)。术后1年、末次随访时三组Wippula功能评价优良率、Wippula影像学复位评价优良率差异均无统计学意义(P>0.05)。[结论]三种手术方式治疗中足Lisfranc损伤在短期内均可取得满意疗效,短期内术后疗效与患肢解剖复位程度有关,与手术固定方式无明显相关性。[Objective] To compare the short-term clinical outcomes of trans-articular screw, dorsal bridging plate and plate-screw combined fixation for treatment of midfoot Lisfranc injury. [Methods] A total of 36 patients underwent open reduction and internal fixation(ORIF) for Lisfranc injury in our department from January 2017 to October 2019. Of them, 15 patients received trans-articular screw, 10 patients had dorsal birding plate, and 11 patients were treated with plate-screw combined fixation. The AOFAS midfoot score, Wippula’s criteria were used to evaluate the postoperative limb function and maintenance of reduction of the three groups. [Results] All patients had operation completed successfully without serious complications such as nerve and vascular injury during the operation. The follow-up period lasted for 12 to 45 months, with an average of(26.24±10.42) months. The AOFAS scores of the three groups increased significantly over time, the differences among different time points were statistically significant(P<0.05). However, there were no significant differences in AOFAS score among the three groups at 6, 12 months after surgery and the latest follow-up(P>0.05). There was no significant difference in the excellent and good rate in term of Wippula’s criteria for function evaluation and imaging reduction evaluation among the three groups at 1 year after operation and at the latest follow-up(P>0.05). [Conclusion] The three surgical techniques do achieve satisfactory shortterm outcomes for Lisfranc injury of the midfoot, which is related to the extent of anatomical reduction of the affected limb, and has no obvious correlation with the surgical techniques.

关 键 词：LISFRANC损伤 中足 钢板 螺钉 疗效 

分 类 号：R683.42[医药卫生—骨科学]