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伴第2跖骨基底部粉碎的Lisfranc损伤的手术治疗
Hits: 2441   Download times: 1519   Received:December 20, 2013    
作者Author单位UnitE-Mail
黄杰烽 HUANG Jie-feng 浙江省中医院, 浙江 杭州 310006  
郑杨 ZHENG Yang 浙江中医药大学, 浙江 杭州 310053 Zhejiang University of TCM, Hangzhou 310053, Zhejiang, China 360847273@qq.com 
陈星 CHEN Xin 浙江省中医院, 浙江 杭州 310006  
赵凯 ZHAO Kai 浙江省中医院, 浙江 杭州 310006  
杜文喜 DU Xi-wen 浙江省中医院, 浙江 杭州 310006  
陈俊杰 CHEN Jun-jie 浙江省中医院, 浙江 杭州 310006  
童培建 TONG Pei-jian 浙江省中医院, 浙江 杭州 310006  
期刊信息:《中国骨伤》2015年28卷,第2期,第171-173页
DOI:10.3969/j.issn.1003-0034.2015.02.017


目的:探讨切开复位内固定治疗伴第2跖骨基底部粉碎的Lisfranc损伤的临床疗效.

方法:选取2007年3月至2012年6月伴第2跖骨基底部粉碎的Lisfranc损伤患者7例,男5例,女2例;年龄22~51岁,平均42岁;扭伤4例,交通伤3例.Myerson分型:A型1足,B型3足,C型3足.在手术内固定同时,用克氏针从内侧楔骨至第2跖骨基底部固定Lisfranc韧带.术后采用美国足踝外科协会(AOFAS)足评分标准进行功能评估;术前、术后摄X线正位、侧位、斜位片及CT检查,进行影像学评估.

结果:所有患者获得随访,时间12~20个月,平均16.8个月.末次随访AOFAS评分(86.1±5.5)分;优3例,良3例,一般1例.所有切口Ⅰ期愈合,未见皮肤坏死,感染,克氏针松动、断裂等并发症.

结论:在手术内固定同时,用克氏针固定伴第2跖骨基底部粉碎的Lisfranc韧带损伤,有良好的临床疗效,可避免行关节融合术.
[关键词]:Lisfranc损伤  骨折,粉碎性  骨折固定术,内  外科手术
 
Surgical treatment for Lisfranc injuries accompanied by the base crashing of the second metatarsal bone
Abstract:

Objective:To discuss the clinical effects of open reduction and internal fixation (ORIF) for treatment of patients with Lisfranc injury combined the second metatarsal base comminuted fracture.

Methods:From March 2007 to June 2012,7 patients with Lisfranc injury combined the second metatarsal base comminuted fracture were treated including 5 males and 2 female aged from 22 to 51 years old (means 42 years),4 of sprain and 3 of traffic injury. According Myerson classification,there was l case of type A,3 of type B and 3 of type C. Kirschner wire was used to fix Lisfranc ligament placing from the medial cuneiform bone to the second metatarsal base during the operation. After the operation American Orthopaedic Foot and Ankle Society (AOFAS) criteria system were applied to evaluate the foot and ankle function. Preoperative and postoperative AP,lateral and oblique X-ray and CT scan were collected for radiographic evaluation.

Results:All patients were followed up from 12 to 20 months (16.8 months in average). According to AOFAS criteria system,3 cases were excellent result,3 good,1 fair. All the wounds were primary healing without skin necrosis,infection,Kirschner loose,broken,or other complications.

Conclusion:Kirschner wire had good clinical efficacy for fixing Lisfranc ligament injury with the second metatarsal base comminuted fracture,and could avoid arthrodesis.
KEYWORDS:Lisfranc injuries  Fractures,comminuted  Fracture fixation,internal  Surgical procedures,operative
 
引用本文,请按以下格式著录参考文献:
中文格式:黄杰烽,郑杨,陈星,赵凯,杜文喜,陈俊杰,童培建.伴第2跖骨基底部粉碎的Lisfranc损伤的手术治疗[J].中国骨伤,2015,28(2):171~173
英文格式:HUANG Jie-feng,ZHENG Yang,CHEN Xin,ZHAO Kai,DU Xi-wen,CHEN Jun-jie,TONG Pei-jian.Surgical treatment for Lisfranc injuries accompanied by the base crashing of the second metatarsal bone[J].zhongguo gu shang / China J Orthop Trauma ,2015,28(2):171~173
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