Sanli Ilknur, Hermus Joris, Poeze Martijn
Maastricht University Medical Centre, Maastricht, The Netherlands.
Musculoskelet Surg. 2012 Jun;96(1):59-62. doi: 10.1007/s12306-011-0150-7. Epub 2011 Jun 25.
The importance of anatomical reduction for improved outcome has been recognised in the management of Lisfranc injuries. Operative fixation is indicated in case of dislocation or unstable ligamentous injury, because discongruity of the Lisfranc joint can lead to deleterious functional outcome. Screws are the recommended method of fixation of the medial en middle column, and K-wires are used for stabilisation of the unstable lateral column. Primary arthrodesis can provide advantages in pure ligamentous injury. In the management of complex open Lisfranc fractures, external fixation with K-wires can be used, but often results in a high percentage of arc deformities and functional limitations. In recent years, there is a progressive change from external to internal fixation in primary stabilisation of open fractures. This case report describes the treatment for a grade III open Lisfranc fracture-dislocation by use of primary internal fixation and soft-tissue reconstruction.
解剖复位对改善Lisfranc损伤治疗效果的重要性已在其治疗中得到认可。对于脱位或不稳定韧带损伤的情况，需进行手术固定，因为Lisfranc关节的不协调会导致不良的功能结果。螺钉是内侧和中柱固定的推荐方法，克氏针用于稳定不稳定的外侧柱。一期关节融合术对单纯韧带损伤可能具有优势。在复杂开放性Lisfranc骨折的治疗中，可使用克氏针进行外固定，但常导致较高比例的弓形畸形和功能受限。近年来，在开放性骨折的初次稳定治疗中，逐渐从外固定转向内固定。本病例报告描述了通过一期内固定和软组织重建治疗III级开放性Lisfranc骨折脱位的情况。
