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足部复杂创伤后的重建足部手术

[Reconstructive foot surgery following complex trauma of the foot].

作者信息

Zwipp H, Tscherne H, Berger A

出版信息

Unfallchirurg. 1989 Mar;92(3):140-54.

PMID:2565601
Abstract

Compound post-traumatic foot deformity may follow indirect, direct, or combined trauma. This is demonstrated by a number of case reports. Particularly during adolescence, primary injuries to the soft tissue, with neurovascular injury or compartment syndrome, and post-traumatic skin contractures can cause severe growth deformity at the site of the injury and distal to it. Compression screw arthrodesis, using the 6.5-mm cancellous screw with the triple arthrodesis and the 3.5-mm cortical screw with the Lisfranc arthrodesis, has particular significance. It is stable, it allows functional treatment later, and bone union takes place rapidly. The most important surgical principles in post-traumatic foot surgery are: precise reconstruction of the foot axes, the medial and lateral foot length, and the longitudinal and transverse arches, i.e., restitution of the normal foot anatomy.

摘要

复合性创伤后足部畸形可能继发于间接、直接或复合创伤。许多病例报告都证实了这一点。特别是在青春期,软组织的原发性损伤,伴有神经血管损伤或骨筋膜室综合征,以及创伤后皮肤挛缩,可导致损伤部位及其远端出现严重的生长畸形。使用6.5毫米的松质骨螺钉进行三关节融合术和使用3.5毫米的皮质骨螺钉进行Lisfranc关节融合术的加压螺钉关节固定术具有特殊意义。它稳定,允许后期进行功能治疗,且骨愈合迅速。创伤后足部手术最重要的手术原则是:精确重建足部轴线、足内外侧长度以及纵弓和横弓,即恢复正常足部解剖结构。

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