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不常规使用经关节螺钉的背侧多钢板固定法治疗Lisfranc损伤

Dorsal multiple plating without routine transarticular screws for fixation of Lisfranc injury.

作者信息

Stern Richard E, Assal Mathieu

出版信息

Orthopedics. 2014 Dec;37(12):815-9. doi: 10.3928/01477447-20141124-03.

Abstract

Following a Lisfranc joint injury, stable fixation of the tarsometatarsal joints is crucial to avoid deformity and posttraumatic osteoarthritis, but the ideal method of fixation remains controversial. Kirschner wire (K-wire) fixation of all involved joints with cast immobilization resulted in loss of position, and was replaced by open reduction with improved fixation using transarticular screws. However, it seems intuitive that transarticular screws will result in further damage to already traumatized joints, and this has led to plate-spanning techniques. The objective of this study was to describe the method of dorsal multiple plating without the routine use of transarticular screws, and to report on the ability of plate fixation to maintain alignment comparable to that of transarticular screw fixation in 15 patients.

摘要

在Lisfranc关节损伤后,跗跖关节的稳定固定对于避免畸形和创伤后骨关节炎至关重要,但理想的固定方法仍存在争议。用石膏固定对所有受累关节进行克氏针(K针)固定会导致位置丢失,随后被切开复位并用经关节螺钉进行改良固定所取代。然而,直观来看,经关节螺钉会对已经受伤的关节造成进一步损伤,这就催生了跨越钢板技术。本研究的目的是描述不常规使用经关节螺钉的背侧多钢板固定方法,并报告钢板固定在15例患者中维持对线的能力,其与经关节螺钉固定相当。

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