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切开复位内固定治疗急性Lisfranc关节损伤的疗效分析

[Effective analysis of open reduction and internal fixation for the treatment of acute Lisfranc joint injury].

作者信息

Zhu Hui, Zhao Hong-mou, Yuan Feng, Yu Guang-rong

机构信息

Department of Orthopaedics, the Affiliated Tongji Hospital of Tongji University, Shanghai 200065, China.

出版信息

Zhongguo Gu Shang. 2011 Nov;24(11):922-5.

PMID:22295488
Abstract

OBJECTIVES

A retrospective study was used to evaluate the short to intermediate outcomes of open reduction and internal fixation of acute Lisfranc joint injuries.

METHODS

From January 2003 to December 2009, 47 patients with Lisfranc injuries were treated in the study,41 patients were analyzed in current study with an average age of thirty-one years old. All of patients were treated with open reduction and internal fixation. According to the Myerson classification system, there were 9 type-A fractures, 7 type-B1, 11 type-B2, 10 type-C1, 5 type-C2. The AOFAS scale and VAS scale were used for the outcome measurement at the final follow-up.

RESULTS

There were 41 patients with 42 operations were followed up and with a mean time of 36 months (ranged, 12 to 71 months). The mean AOFAS score was (84.2 +/- 2.8) points (ranged, 65 to 100 points), with an excellent and good rate of 81 percent. The mean VAS score was (2.6 +/- 0.5) points (ranged, 0 to 6 points). Three patients developed superficial infection, and two developed skin necrosis. Nineteen patients had weight-bearing or walking pain. All of the patients had radiographic evidence of degenerative change, four with malunion of the second tarsometatarsal joint, and two of the patients with hallux valgus deformity change.

CONCLUSION

According to the results of the study, anatomic reduction and internal fixation can get the satisfactory results for the treatment of acute Lisfranc injuries during a short to intermediate follow-up time. All of the patients would have different degree of tarsometatarsal joint degenerative changes, but these changes are non-progressive and associated with minimal loss of function.

摘要

目的

采用回顾性研究评估急性Lisfranc关节损伤切开复位内固定术的近期至中期疗效。

方法

2003年1月至2009年12月,本研究共治疗47例Lisfranc损伤患者,本研究分析了41例患者,平均年龄31岁。所有患者均接受切开复位内固定治疗。根据Myerson分类系统,有9例A型骨折,7例B1型,11例B2型,10例C1型,5例C2型。末次随访时采用AOFAS量表和VAS量表评估疗效。

结果

41例患者共进行了42次手术,平均随访时间为36个月(范围12至71个月)。平均AOFAS评分为(84.2±2.8)分(范围65至100分),优良率为81%。平均VAS评分为(2.6±0.5)分(范围0至6分)。3例患者发生浅表感染,2例出现皮肤坏死。19例患者有负重或行走疼痛。所有患者均有影像学证据显示存在退行性改变,4例第二跗跖关节畸形愈合,2例患者有拇外翻畸形改变。

结论

根据本研究结果,解剖复位内固定治疗急性Lisfranc损伤在近期至中期随访期内可获得满意疗效。所有患者均会出现不同程度的跗跖关节退行性改变,但这些改变不会进展,且功能丧失最小。

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引用本文的文献

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EPIDEMIOLOGICAL STUDY ON LISFRANC INJURIES.跖跗关节损伤的流行病学研究。
Acta Ortop Bras. 2017 Jan-Feb;25(1):44-47. doi: 10.1590/1413-785220172501168995.
2
Does Open Reduction and Internal Fixation versus Primary Arthrodesis Improve Patient Outcomes for Lisfranc Trauma? A Systematic Review and Meta-analysis.切开复位内固定术与一期关节融合术相比,是否能改善 Lisfranc 创伤患者的预后?一项系统评价和荟萃分析。
Clin Orthop Relat Res. 2016 Jun;474(6):1445-52. doi: 10.1007/s11999-015-4366-y.