关于lisfranc损伤的一种新临床分型应用分析  

Application analysis of a new clinical classification of lisfranc injury

作　　者：李渊[1] 吕智[1] 罗华云[1] 侯福山 李栋[1] Li Yuan;Lv Zhi;Luo Huayun;Hou Fushan;Li Dong(Department of Foot and Ankle Surgery,Second Hospital of Shanxi Medical University,Taiyuan 030001,Shanxi,China)

机构地区：[1]山西医科大学第二医院足踝外科,山西太原030001

出　　处：《足踝外科电子杂志》2024年第3期29-35,共7页Electronic Journal of Foot and Ankle Surgery

基　　金：吴阶平医学基金会科研专项资助基金(320.6750.2024-11-15)。

摘　　要：目的探讨Lisfranc损伤一种新分型方法在治疗的临床应用价值。方法2020年4月至2023年4月,在山西医科大学第二医院39例闭合性Lisfranc损伤患者接受治疗,所有患者在软组织条件允许下择期行手术治疗。术前、术后采用美国足踝外科协会(American Orthopaedic Foot and Ankle Society,AOFAS)中足评分和视觉模拟评分法(visual analogue scale,VAS)评分评价治疗效果。结果术后平均随访时间13.4(12~24)个月,手术切口愈合良好。无骨不连,骨折畸形愈合以及因接骨板螺钉松动、脱出、断裂及异物反应等与内植入物相关的并发症。患者平均术后5.2(3~7)个月完全负重行走。所有患者术后6个月、12个月的AOFAS中足评分和VAS评分与术前对比,差异有统计学意义(P<0.001)。术后6个月,2例患者行走时仍有足部不适感,1例发生轻度创伤性关节炎,长时间行走疼痛。术后12个月,根据AOFAS评分标准:优23例,良10例,可5例,差1例,优良率为84.6%。结论新的分型系统将高能量损伤分型及低能量分型结合起来,同时将lisfranc损伤中合并损伤考虑在内,进行了更详细的分类。同时可以根据具体的损伤类型来制订手术方案,可以有效地指导Lisfranc损伤的临床治疗。Objective To explore the clinical application value of a new classification method for Lisfranc injury in the treatment of lisfranc injury.Methods From April 2020 to April 2023,39 patients with closed Lisfranc injuries were treated at Second Hospital of Shanxi Medical University,and all patients underwent surgical treatment when soft tissue conditions allowed.Preoperative and postoperative evaluation of treatment outcomes was conducted using the American Orthopaedic Foot and Ankle Society(AOFAS)midfoot score and visual analog scale(VAS)score.Results The average follow-up time after surgery was 13.4(12~24)months.Surgical incisions healed well without bone nonunion or malunion,and there were no complications related to implant loosening,protrusion,fra cture,or foreign body reaction.Patients achieved full weight-bearing walking at an average of 5.2(3~7)months postoperatively.At 6 months and 12 months postoperatively,the AOFAS midfoot score and VAS score both showing statistically significant differences compared to preoperative scores(P<0.001).At 6 months postoperatively,two patients still experienced foot discomfort while walking,and one developed mild traumatic arthritis with prolonged walking pain.At 12 months postoperatively,according to the AOFAS score criteria,there were 23 excellent,10 good,5 fair,and 1 poor result,with an excellent/good rate of 84.6%.Conclusion The new classification system combines high-energy and low-energy injury classifications,while also considering associated injuries in Lisfranc injuries,leading to a more detailed categorization.Based on the specific injury type,it helps in formulating surgical plans,which can effectively guide clinical treatment of Lisfranc injuries.

关 键 词：LISFRANC损伤 内固定治疗 美国足踝外科协会 分型 

分 类 号：R681[医药卫生—骨科学]