Wang Li-Pei, Yang Chuan, Huang Jie-Feng, Shen Jian-Jian, He Chuan, Tong Pei-Jian
Acta Orthop Belg. 2017 Sep;83(3):396-404.
The objective of this retrospective study was to compare open reduction and internal fixation (ORIF) with primary partial arthrodesis for the treatment of Lisfranc injuries accompanied by comminution of the second metatarsal base. Thirty-four patients were treated with ORIF or primary partial arthrodesis from 2007 to 2013. The patients were followed for an average of 28.5 months. Evaluation was performed with clinical examination, radiography, Visual Analogue Scale (VAS), the American Orthopedic Foot and Ankle Society (AOFAS) Midfoot Score, and the Short Form 36 (SF-36). Fifteen patients were treated with ORIF, and nineteen patients were treated with primary partial arthrodesis. Anatomical reduction was obtained in all patients. At two years postoperatively, the mean AOFAS Midfoot score was 84.33 points in the ORIF group and 85.05 points in the primary partial arthrodesis group (P> 0.05). Also, no significant differences were seen in the VAS for pain (1.20 vs 1.05 points), SF-36 physical component (79.60 vs 79.89 points) or SF-36 mental component (77.07 vs 79.21 points). With longer and conservative postoperative management, ORIF as well as primary partial arthrodesis for Lisfranc injuries accompanied by comminution of the second metatarsal base led to similar medium-term outcome.
这项回顾性研究的目的是比较切开复位内固定术（ORIF）与一期部分关节融合术治疗伴有第二跖骨基底粉碎性骨折的Lisfranc损伤的效果。2007年至2013年期间，34例患者接受了ORIF或一期部分关节融合术治疗。患者平均随访28.5个月。通过临床检查、X线摄影、视觉模拟评分（VAS）、美国矫形足踝协会（AOFAS）中足评分和简明健康状况调查量表（SF-36）进行评估。15例患者接受了ORIF治疗，19例患者接受了一期部分关节融合术治疗。所有患者均获得了解剖复位。术后两年，ORIF组的平均AOFAS中足评分为84.33分，一期部分关节融合术组为85.05分（P>0.05）。此外，在疼痛VAS评分（1.20分对1.05分）、SF-36身体成分评分（79.60分对79.89分）或SF-36精神成分评分（77.07分对79.21分）方面均未观察到显著差异。通过更长时间的保守术后管理，对于伴有第二跖骨基底粉碎性骨折的Lisfranc损伤，ORIF以及一期部分关节融合术均能带来相似的中期疗效。
