Lesko Gina, Altman Kyle, Hogue Grant
Department of Orthopaedics, The University of Texas Health Science Center at San Antonio, San Antonio, TX.
J Am Acad Orthop Surg Glob Res Rev. 2018 Mar 8;2(3):e004. doi: 10.5435/JAAOSGlobal-D-17-00004. eCollection 2018 Mar.
We present a case of a 10-year-old girl who sustained a Lisfranc fracture-dislocation after an all-terrain vehicle accident. She underwent open reduction and internal fixation with smooth Kirschner wires. At 5-year follow-up, she had developed functional pain and radiographic evidence of degenerative arthritis and partial fusion of her midfoot. There are several possible explanations for this outcome, including loss of reduction, traumatic or iatrogenic physeal injury, and severity of initial injury. Long-term outcomes in children with Lisfranc injuries are not well described. Our case may begin to shed light on the natural history of these injuries in the pediatric population, with the consideration of potential treatment implications and pitfalls.
我们报告一例10岁女孩,她在全地形车事故后发生了Lisfranc骨折脱位。她接受了切开复位并用光滑克氏针内固定。在5年的随访中,她出现了功能性疼痛以及退行性关节炎和中足部分融合的影像学证据。对于这一结果有几种可能的解释,包括复位丢失、创伤性或医源性骨骺损伤以及初始损伤的严重程度。Lisfranc损伤儿童的长期预后尚无详尽描述。我们的病例可能有助于揭示这些损伤在儿科人群中的自然病程,同时考虑潜在的治疗意义和陷阱。