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手术治疗Lisfranc关节损伤13例的疗效分析
Hits: 2561   Download times: 1385   Received:May 18, 2012    
作者Author单位UnitE-Mail
许桦 XU Hua 杭州市萧山区第一人民医院骨二科, 浙江 杭州 311201 The Second Department of Orthopaedics, the First People's Hospital of Xiaoshan, Hangzhou 311201, Zhejiang, China xxuoo365@yahoo.com.cn 
毕大卫 BI Da-wei 杭州市萧山区第一人民医院骨二科, 浙江 杭州 311201 The Second Department of Orthopaedics, the First People's Hospital of Xiaoshan, Hangzhou 311201, Zhejiang, China  
马海涛 MA Hai-tao 杭州市萧山区第一人民医院骨二科, 浙江 杭州 311201 The Second Department of Orthopaedics, the First People's Hospital of Xiaoshan, Hangzhou 311201, Zhejiang, China  
王辉 WANG Hui 杭州市萧山区第一人民医院骨二科, 浙江 杭州 311201 The Second Department of Orthopaedics, the First People's Hospital of Xiaoshan, Hangzhou 311201, Zhejiang, China  
陈亿民 CHEN Yi-min 杭州市萧山区第一人民医院骨二科, 浙江 杭州 311201 The Second Department of Orthopaedics, the First People's Hospital of Xiaoshan, Hangzhou 311201, Zhejiang, China  
杨育生 YANG Yu-sheng 杭州市萧山区第一人民医院骨二科, 浙江 杭州 311201 The Second Department of Orthopaedics, the First People's Hospital of Xiaoshan, Hangzhou 311201, Zhejiang, China  
祖罡 ZU Gan 杭州市萧山区第一人民医院骨二科, 浙江 杭州 311201 The Second Department of Orthopaedics, the First People's Hospital of Xiaoshan, Hangzhou 311201, Zhejiang, China  
期刊信息:《中国骨伤》2013年26卷,第4期,第344-346页
DOI:10.3969/j.issn.1003-0034.2013.04.020


目的: 探讨手术治疗Lisfranc关节损伤的临床疗效及影响因素。

方法: 自2009年1月至2011年11月, 共收治Lisfranc关节损伤13例14足, 男9例, 女4例;年龄18~61岁, 平均42岁。Myerson分型:A型1足, B型9足, C型4足。所有患者在伤后22 d内接受手术, 手术采用切开复位螺钉或克氏针内固定(1例开放性采用外固定架固定).术后采用美国足踝外科协会(American Orthopaedic Foot and Ankle Society,AOFAS)足评分标准进行功能评估;术前、术后摄X线正斜或侧位片, 进行影像学评估。

结果: 所有患者获得随访, 时间5~30个月, 平均20个月。术后根据AOFAS足评分, 优8足, 良4足, 中2足。X线片示12例获得解剖复位, 所有患者骨性愈合。1例出现皮肤切缘坏死, 经换药后愈合;1例开放性骨折皮肤回植后出现坏死, 行皮瓣修复后愈合。其余病例未见任何手术并发症。

结论: 切开复位内固定是治疗Lisfrancs关节损伤的有效方法, 术前软组织损伤的评估、术中骨折复位及术后复位的维持可影响临床结果。
[关键词]:  创伤和损伤  骨折固定术,内
 
Curative effect analysis of surgical treatment of Lisfranc joint injuries
Abstract:

Objective: To investigate the clinical results and influence factors in surgical treatment of the Lisfranc joint injury.

Methods: From Jan. 2009 to Nov. 2011,13 patients (14 feet) with Lisfranc joint injury received open reduction and screw or wire or external fixation including 9 males and 4 females with an average age of 42 years old ranging from 18 to 61 years. According to the Myerson classification,there were 1 case of type A,9 of type B and 4 of type C. All the patients received open reduction and internal (1 with external) fixation with screw or Kirschner wire within 22 days after injury. The post-operative function was estimated by mid-foot scoring scale of AOFAS. X-ray were used in radiography estimation.

Results: All the patients were followed up for 5 to 30 months (averaged 20 months). According to mid-foot scoring scale of AOFAS,there were 8 feet with excellent results,4 with good and 2 with fair results. The anatomical reduction was observed in 12 feet and all the patients obtained bony union according to the results of X-ray.

Conclusion: Open reduction and internal fixation is a good choice for the treatment of Lisfranc joint injury. A preoperative estimate,proper reduction during operation and maintainence after operation may influence the clinical results.
KEYWORDS:Foot  Wounds and injuries  Fracture fixation,internal
 
引用本文,请按以下格式著录参考文献:
中文格式:许桦,毕大卫,马海涛,王辉,陈亿民,杨育生,祖罡.手术治疗Lisfranc关节损伤13例的疗效分析[J].中国骨伤,2013,26(4):344~346
英文格式:XU Hua,BI Da-wei,MA Hai-tao,WANG Hui,CHEN Yi-min,YANG Yu-sheng,ZU Gan.Curative effect analysis of surgical treatment of Lisfranc joint injuries[J].zhongguo gu shang / China J Orthop Trauma ,2013,26(4):344~346
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