摘要
背景:近年来Lisfranc损伤的发病率有上升趋势,其治疗和固定方法众多,但目前尚未达成共识。目的:探讨分柱显露、复位、固定治疗闭合性三柱均受累的Lisfranc损伤的临床疗效。方法:回顾性分析2015年1月至2018年6月采用分柱显露、复位、固定治疗的30例闭合性三柱均受累的Lisfranc损伤患者的临床资料,其中男23例,女7例;年龄22~65岁,平均(33.2±7.2)岁。患者受伤至手术时间为8~14 d,平均(9.5±1.4)d。美国足踝外科协会(AOFAS)中足评分和视觉模拟评分(VAS)评估临床疗效,随访观察临床结果和并发症情况。结果:30例患者随访时间18~28个月,平均(22.0±3.2)个月,术后28例切口一期愈合,2例切口皮缘发黑,经过加强换药处理,二期愈合,无血管及神经损伤。末次随访时AOFAS评分为(83.5±4.2)分,VAS评分为(1.6±0.8)分;3例跨接骨板固定关节接骨板断裂,行内固定取出,无临床症状。结论:分柱显露、复位、固定治疗三柱同时受累的Lisfranc损伤,具有直视下复位好、固定牢固、功能恢复好的特点,临床疗效满意。
Background:The incidence of Lisfranc injury has been increasing in recent years.As there is no consensus on its treatment,there are many methods of treatment and fixation.Objective:To investigate the clinical effect of separate exposure,reduction and fixation on closed three-column involved Lisfranc injury.Methods:Clinical data of 30 patients with Lisfranc injury treated from January 2015 to June 2018 were analyzed retrospectively.There were 23 males and 7 females with a mean age of(33.2±7.2)years old(range,22-65 years old).The mean time from injury to operation was(9.5±1.4)d(range,8-14 d).Clinical outcomes and complications were evaluated with the American Orthopaedic Foot and Ankle Society(AOFAS)midfoot score and visual analogue scale(VAS).Results:The mean duration of follow-up was(22.0±3.2)months(range,18-28 months)in these patients.Primary wound healing achieved in 28 patients,and black skin edge was found in 2 patients which healed after dressing change.There was no injury of vessels or nerves.At the last follow-up,the AOFAS score was 83.5±4.2 and VAS score was 1.6±0.8;there were 3 cases of fracture of the joint plate which was fixed across the plate and removed by internal nxation without clinical symptoms.Conclusions:The treatment of Lisfranc injury involving three columns by separate column exposure,reduction and fixation has the characteristics of good reduction under direct vision,firm fixation and good functional recovery.The clinical curative effect is satisfactory.
作者
王振
明晓锋
俞光荣
李西要
苏攀
杨生民
刘青
冯彦江
王社言
杨波
WANG Zhen;MING Xiaofeng;YU Guangrong;LI Xiyao;SU Pan;YANG Shengmin;LIU Qing;FENG Yanjiang;WANG Sheyan;YANG Bo(Luoyang Orthopaedic Traumatological Hospital,Orthopaedics Hospital of Henan Province,Luoyang 471002,Henan;Tongji Hospital of Tongji University,Shanghai 200065,China)
出处
《中华骨与关节外科杂志》
2021年第9期769-772,783,共5页
Chinese Journal of Bone and Joint Surgery
