Department of Orthopaedics, The Ohio State University Medical Center, Columbus, OH, USA.
Phys Sportsmed. 2010 Dec;38(4):119-26. doi: 10.3810/psm.2010.12.1834.
The subtle clinical and radiographic findings of an unstable Lisfranc ligament injury can be easily misdiagnosed as a stable midfoot sprain. Appropriate treatment ranges from conservative management to surgery, depending on the extent of ligament disruption and subsequent joint instability. Initial evaluation with non-weight bearing radiographs is often normal in unstable injuries. The results of missed or inappropriately treated Lisfranc injuries are poor. Chronic joint instability can lead to persistent pain, degenerative joint disease, and decreased functional capacity. Inability to return to previous levels of activity may result from painful midfoot arthritis. It is important to have a high index of suspicion for unstable Lisfranc injuries in patients who present with midfoot pain after low-energy injuries. Stress radiographs and magnetic resonance imaging can help differentiate between stable and unstable ligament sprains. Referral to an orthopedic surgeon is appropriate for injuries that result in joint diastasis. Long-term outcomes are optimized by early anatomic reduction.
不稳定的跖跗关节韧带损伤的细微临床和影像学表现容易被误诊为稳定的中足扭伤。根据韧带断裂和随后的关节不稳定程度，适当的治疗范围从保守治疗到手术治疗。不稳定损伤的初始非负重 X 线片常正常。漏诊或处理不当的跖跗关节损伤结果不佳。慢性关节不稳定可导致持续性疼痛、退行性关节疾病和功能能力下降。中足关节炎可导致无法恢复到以前的活动水平。对于低能量损伤后出现中足疼痛的患者，高度怀疑不稳定的跖跗关节损伤非常重要。应力 X 线片和磁共振成像有助于区分稳定和不稳定的韧带扭伤。对于导致关节分离的损伤，应转介给矫形外科医生。早期解剖复位可优化长期结果。
