Gotha Heather E, Lareau Craig R, Fellars Todd A
Senior orthopaedic resident, Dept. of Orthopaedics,The Warren Alpert Medical School of Brown University and Rhode Island Hospital.
R I Med J (2013). 2013 May 1;96(5):33-6.
Forefoot and midfoot injuries are relatively common and can lead to chronic disability, especially if they are not promptly diagnosed and appropriately treated. A focused history and physical examination must be coupled with a thorough review of imaging studies to identify the correct diagnosis. Subtle radiographic changes can represent significant ligamentous Lisfranc injury. Midfoot swelling in the presence of plantar ecchymosis should be considered to be a Lisfranc injury until proven otherwise. While most metatarsal fractures can be treated with some form of immobilization and protected weight-bearing, this article will distinguish these more common injuries from those requiring surgical intervention. We will review relevant anatomy and biomechanics, mechanisms of injury, clinical presentation, imaging studies, and diagnostic techniques and treatment.
前足和中足损伤相对常见,可能导致慢性残疾,尤其是在未及时诊断和适当治疗的情况下。重点病史和体格检查必须结合对影像学研究的全面评估,以确定正确诊断。细微的影像学改变可能提示严重的Lisfranc韧带损伤。在足底瘀斑存在的情况下,中足肿胀在未被证伪前应考虑为Lisfranc损伤。虽然大多数跖骨骨折可以通过某种形式的固定和保护性负重治疗,但本文将把这些较常见的损伤与需要手术干预的损伤区分开来。我们将回顾相关的解剖学和生物力学、损伤机制、临床表现、影像学研究以及诊断技术和治疗方法。