摘要
目的探讨跨关常钢板内固定治疗跖跗关节损伤的手术治疗方法和临床疗效、方法F12009年5月至2011年5月共收治31例跖骨基粉碎性跖跗关节损伤患者，男19例，女12例；年龄24～70岁，平均46．2岁；均为闭合性损伤，其中8例损伤累及跖跗父节复合体，2例合肝骰骨压缩性骨折。所有患者待软组织条件改善后，择期行切开复位跨天节钢板内固定术。术后采用美国足踝外科饥会（AOFAS）中足评分、简明健康调查量表（SF-36）评分和视觉模拟评分（VAS）评价治疗效果，外记录卡相关并发症．结果25例患者术后获12～36个月（平均24个月）随访，随访期间末见伤口感染、皮瓣坏死等软组织并发症。X线片示术后平均12周（10～15周）骨性愈合，末次随访时AOFAS中足分为45～95分（平均78.0分），SF-36评分为45～96分（平均79．2分），VAS坪分为0～8分（平均I．7分）：1例跖跗关竹复合体损伤患者术后9个月复查时发现螺钉断裂，但无不适主诉，蚕宝宝、以取出内固定；2例跖跗父竹复合体损伤患者分别于术后14、20个月发生创伤性关节炎，均行跖跗关节融合术。结论跨关节钢板内幽定治疗跖跗关协损伤技术简单，可避免关节面软骨的再损伤，是治疗跖跗关节损伤安全、有效的方法。
Objective To evaluate clinical outcomes of dorsal spanning plate in treatment of tarsometatarsal joint injury. Methods Between May 2009 and May 2011, 31 eases of ch）sed tarsomelalarsal joint injury with comminuted fracture of the metatarsal base were treated in our department. They were 19 males anti 12 females, with an average age of 46.2 years （from 24 to 70 years） . Tim tarsometatarsal joint complex was involved in 8 cases. An open reduction and dorsal spanning plate fixation was performed after the soft tissue situation was ameliorated. Regular X-ray follow-ups were carried out tn evaluate overall outcomes nsing American Orthopaedics Foot and Ankle Society （AOFAS） midfoot score, 36-item Short Mos Form Heahh Survey （SF-36 score） and visual analogue scale （VAS）, and complications were also recorded. Results Of all the patients, 25 were fi）llowed up for an average of 24 munths （from 12 to 36 months）. There were no such soft tissue complications as wound infection, skin anti flap necrosis. X-ray demonstrated bony union at an average of 12 weeks （from 10 tu 15 weeks） postoperatiun. The average AOFAS midfoot score was 78.0 points （from 45 to 95 points）, SF-36 score 79.2 points （from 45 to 96 points） and VAS score 1.7 points （from 0 to 8 points） at the final follow-up. Screw breakage was found in one patient without complaints at 9 months posh）peration and the implant was removed. Obvious pain and limited function caused by post-traumatic arthritis were found at 14 months and 20 months postoperation respectively in 2 patients who had to undergo an arthrodesis eventually. Conclusion Treatment of tarsometatarsal joint injury with dorsal spanning plate is sate and effective, with advantages of operative simplicity and avoidance of iatrogenic damage of articular cartilage.
出处
《中华创伤骨科杂志》
CAS
CSCD
北大核心
2013年第3期198-201,共4页
Chinese Journal of Orthopaedic Trauma
关键词
足损伤
骨板
骨折固定术
内
Foot injuries
Bone plates
Fracture fixation, internal
