早期切开减压并螺钉固定治疗Lisfranc损伤 并足骨筋膜室综合征  

Early incision,decompression and screw fixation for the treatment of Lisfranc injuries with foot osteofascial compartment syndrome

作　　者：宋锦旗 欧阳夏辉 卢光远 黄定根 王雪冰 邓雪峰 SONG Jin-qi;OUYANG Xia-hui;LU Guang-yuan;HUANG Ding-gen;WANG Xue-bing;DENG Xue-feng(Department of Traumatology and Orthopaedics,Central Hospital of Longhua District,Shenzhen 518110,Guangdong,China;不详)

机构地区：[1]深圳市龙华区中心医院创伤骨科,广东深圳518110 [2]新疆喀什市人民医院骨科,新疆喀什844000

出　　处：《中国骨伤》2021年第5期471-475,共5页China Journal of Orthopaedics and Traumatology

基　　金：广东省自然科学基金资助项目(编号:2018A030313801)。

摘　　要：目的:探讨早期切开减压并螺钉固定治疗Lisfranc损伤并足骨筋膜室综合征的临床疗效。方法:回顾性分析2017年1月至2018年12月收治的5例Lisfranc损伤并足部骨筋膜室综合征患者的临床资料,其中男4例,女1例;年龄19~62岁。均为闭合性损伤。受伤至就诊时间1~14 h。根据Myerson分型法,A型1例,B型1例,C型3例。均行早期切开减压并螺钉固定治疗。术后12个月采用Maryland足部功能评分标准对其临床疗效进行评价。结果:所有患者获得随访,时间10~24个月。骨折均获得骨性愈合,愈合时间3~9个月,复位者跖跗关节全部达到解剖复位。无感染、骨髓炎、内固定物松动或断裂等并发症发生。术后12个月Maryland足部功能评分44~97分,其中优2例,良2例,差1例。结论:早期切开减压并螺钉固定治疗Lisfranc损伤并足骨筋膜室综合征,手术操作简便,减压彻底,螺钉固定不占用空间,减压及固定效果可靠,治疗效果满意。Objective:To explore clinical effect of early incision and decompression combined with screw fixation in treating Lisfranc injury and foot osteofascial compartment syndrome.Methods:Clinical data of 5 patients with Lisfranc injury and foot osteofascial compartment syndrome were retrospective analysized from January 2017 to December 2018,including 4 males and 1 female,aged from 19 to 62 years old.All patients were suffered from closed injuries.The time from injury to treatment ranged from 1 to 14 h.According to Myerson classification,1 patient was type A,1 patient was type B,and 3 patients were type C.All patients were performed early incision decompression and screw fixation.Maryland foot functional scoring standard at 12 months after opertaion was used to evaluate clinical effect.Results:All patients were followed up for 10 to 48 months.All fractures were achieved bone union,and healing time ranged from 3 to 9 months.All metatarsal and tarsal joints were reached to anatomical reduction.No infection,osteomyelitis,loosening or breaking of internal fixation occurred.Postopertaive Maryland foot function score at 12 months was from 44 to 97,and 2 patients got excellent result,2 good,and 1 poor.Conclusion:Early incision and decompression with screw fixation for the treatment of Lisfranc injury and foot osteofascial compartment syndrome,which has advantages of simple opertaion,thoroughly decompression,screw fixation does not occupy space,stable decompression and fixation,and could receive satisfied clinical effect.

关 键 词：踝损伤 筋膜切开术 减压术 外科 

分 类 号：R687.2[医药卫生—骨科学]