| 切开复位内固定治疗新鲜跖跗关节损伤的疗效分析 |
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投稿时间：2011-05-31
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| 作者 | Author | 单位 | Address | E-Mail |
| 朱辉 |
ZHU Hui |
同济大学附属同济医院骨科，上海 200065 |
Department of Orthopaedics, the Affiliated Tongji Hospital of Tongji University, Shanghai 200065, China |
zhuhui895@sina.com |
| 赵宏谋 |
ZHAO Hong-mou |
同济大学附属同济医院骨科，上海 200065 |
Department of Orthopaedics, the Affiliated Tongji Hospital of Tongji University, Shanghai 200065, China |
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| 袁锋 |
YUAN Feng |
同济大学附属同济医院骨科，上海 200065 |
Department of Orthopaedics, the Affiliated Tongji Hospital of Tongji University, Shanghai 200065, China |
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| 俞光荣 |
YU Guang-rong |
同济大学附属同济医院骨科，上海 200065 |
Department of Orthopaedics, the Affiliated Tongji Hospital of Tongji University, Shanghai 200065, China |
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| 期刊信息：《中国骨伤》2011年，第24卷，第11期，第922-925页 |
| DOI：10.3969/j.issn.1003-0034.2011.11.012 |
| 基金项目: |
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中文摘要:
目的：通过回顾性研究，对切开复位内固定治疗新鲜Lisfranc关节骨折脱位的中短期疗效进行分析。
方法：2003年1月至2009年12月，收治新鲜Lisfranc关节骨折脱位47例，其中41例(42足)纳入研究，平均年龄31岁。按照Myerson分型：A型9足，B1型7足，B2型11足，C1型10足，C2型5足。术后末次随访时采用美国足踝骨科协会AOFAS评分量表和VAS疼痛量表进行评估。
结果：41例患者均获随访，平均随访时间36个月(12～71个月).平均AOFAS得分为(84.2±2.8)分(65～100分),优良率为81%,其中Myerson A型和C型的评分存在差异(P=0.02).平均VAS得分为(2.6±0.5)分(0～6分).3例出现浅表感染，2例皮缘坏死。有19例患者存在负重及行走痛，所有患者存在不同程度的跖跗关节退变，4例出现跖骨骨折畸形愈合，2例出现拇外翻畸形。
结论：新鲜Lisfranc关节骨折脱位的治疗，解剖复位内固定可以取得较好的治疗效果；虽然跖跗关节退变不可避免，但并不影响功能愈后。 |
| 【关键词】跖骨 跗关节 骨折 脱位 关节融合术 骨折固定术，内 |
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| Effective analysis of open reduction and internal fixation for the treatment of acute Lisfranc joint injury |
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ABSTRACT
Objectives: A retrospective study was used to evaluate the short to intermediate outcomes of open reduction and internal fixation of acute Lisfranc joint injuries.
Methods: From January 2003 to December 2009, 47 patients with Lisfranc injuries were treated in the study, 41 patients were analyzed in current study with an average age of thirty-one years old. All of patients were treated with open reduction and internal fixation. According to the Myerson classification system, there were 9 type-A fractures, 7 type-B1, 11 type-B2, 10 type-C1, 5 type-C2. The AOFAS scale and VAS scale were used for the outcome measurement at the final follow-up.
Results: There were 41 patients with 42 operations were followed up and with a mean time of 36 months (ranged, 12 to 71 months). The mean AOFAS score was (84. 2±2. 8) points(ranged, 65 to 100 points), with an excellent and good rate of 81 percent. The mean VAS score was (2. 6±0. 5) points(ranged, 0 to 6 points). Three patients developed superficial infection, and two developed skin necrosis. Nineteen patients had weight-bearing or walking pain. All of the patients had radiographic evidence of degenerative change, four with malunion of the second tarsometatarsal joint, and two of the patients with hallux valgus deformity change.
Conclusion: According to the results of the study, anatomic reduction and internal fixation can get the satisfactory results for the treatment of acute Lisfranc injuries during a short to intermediate follow-up time. All of the patients would have different degree of tarsometatarsal joint degenerative changes, but these changes are nonprogressive and associated with minimal loss of function. |
| KEY WORDS Metatarsal bones Tarsal joints Fractures Dislocations Arthrodesis Fracture fixation, internal |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 朱辉,赵宏谋,袁锋,俞光荣.切开复位内固定治疗新鲜跖跗关节损伤的疗效分析[J].中国骨伤,2011,24(11):922~925 |
| 英文格式: | ZHU Hui,ZHAO Hong-mou,YUAN Feng,YU Guang-rong.Effective analysis of open reduction and internal fixation for the treatment of acute Lisfranc joint injury[J].zhongguo gu shang / China J Orthop Trauma ,2011,24(11):922~925 |
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