Markowitz H D, Chase M, Whitelaw G P
Department of Orthopaedic Surgery, Boston City Hospital, Massachusetts 02118.
Clin Orthop Relat Res. 1989 Nov(248):210-2.
Injuries to tarsometatarsal (Lisfranc) joints are subtle, potentially disabling, and are still often overlooked. This case report of a rare isolated second Lisfranc joint dislocation (LJD) in a 46-year-old woman illustrates the typically subtle roentgenographic findings. A careful scrutiny of the base of the second metatarsal bone, especially on the lateral roentgenogram, shows alignment with the middle cuneiform. On an oblique view of the foot, the fourth metatarsal base should be aligned to the medial edge of the cuboid. Closed reduction of LJD is often unsuccessful and, if achieved, is often unstable. Soft-tissue or chondral fragment interposition impedes reduction. Open reduction and internal fixation are recommended.
跗跖（Lisfranc）关节损伤较为隐匿，可能导致残疾，且常常被忽视。本病例报告了一名46岁女性罕见的孤立性第二Lisfranc关节脱位（LJD），阐述了典型的隐匿性X线表现。仔细观察第二跖骨基底，尤其是在足部外侧X线片上，可见其与中间楔骨对线良好。在足部斜位片上，第四跖骨基底应与骰骨内侧缘对齐。LJD的闭合复位通常不成功，即便成功，也往往不稳定。软组织或软骨碎片嵌入会妨碍复位。建议行切开复位内固定术。
