Ochman S, Evers J, Raschke M J
Klinik und Poliklinik für Unfall-, Hand- und Wiederherstellungschirurgie, Universitätsklinikum Münster, Albert Schweitzer Campus 1, Gebäude W1, 48149, Münster, Deutschland.
Unfallchirurg. 2011 Oct;114(10):883-92. doi: 10.1007/s00113-011-1981-2.
Injuries of the midfoot are often missed and therefore underestimated. The diagnosis and primary treatment are crucial for the outcome. An accurately made diagnosis and therapy initially can anticipate the extent of post-traumatic malpositioning, arthrosis and the number of subsequent surgeries. Diagnostics should liberally include computed tomography with multiplanar reconstructions; clinically a compartment syndrome should be treated at an early stage. Surgery includes anatomical reconstruction of the relevant joints and ligamentous structures and restoration of axes and lengths of the columns of the foot. Innovations comprise intraoperative 3-D imaging and computer-assisted surgery for quality control. New methods for ligamentous injuries are transosseous suturing and endobutton techniques, which have not yet become established.
中足损伤常常被漏诊，因此未得到充分重视。诊断和初期治疗对预后至关重要。准确的诊断和初始治疗能够预估创伤后畸形、关节病的程度以及后续手术的次数。诊断应广泛采用多平面重建的计算机断层扫描；临床上，骨筋膜室综合征应尽早治疗。手术包括对相关关节和韧带结构进行解剖重建，以及恢复足部各柱的轴线和长度。创新技术包括术中三维成像和计算机辅助手术以进行质量控制。韧带损伤的新方法有经骨缝合和纽扣钢板技术，但尚未广泛应用。
