Pérez Blanco R, Rodríguez Merchán C, Canosa Sevillano R, Munuera Martínez L
Department of Orthopaedic Surgery, La Paz Hospital, University Autónoma, Madrid, Spain.
J Orthop Trauma. 1988;2(3):188-94. doi: 10.1097/00005131-198802030-00003.
A total of 32 cases of tarsometatarsal fracture dislocations, treated during a 15-year period, have been retrospectively reviewed. Results were assessed in 29 patients with a mean age of 33.8 years and a mean follow-up of 6.3 years. On the basis of Quénu and Küss' classification, five patients had homolateral dislocations, three had divergent dislocations, and 21 had partial dislocations (seven medial partial and 14 lateral partial). Treatment included closed manipulative reduction, occasionally followed by Kirschner (K)-wire fixation. If closed reduction was not achieved, open reduction was performed. Results were assessed according to Hardcastle's scoring system. On that basis, 20 good, 5 fair, and 3 poor results were obtained and there was one early amputation. Good results were associated with an accurate reduction. Open treatment is advocated if minor displacement persists. Routine K-wire fixation is advised for all cases.
回顾性分析了15年间共32例跗跖骨骨折脱位患者的治疗情况。对29例患者进行了结果评估，患者平均年龄33.8岁，平均随访6.3年。根据Quénu和Küss分类，5例为同侧脱位，3例为分离性脱位，21例为部分脱位（7例内侧部分脱位和14例外侧部分脱位）。治疗包括闭合手法复位，偶尔辅以克氏针固定。若无法实现闭合复位，则行切开复位。根据Hardcastle评分系统评估结果。据此，获得20例优、5例良和3例差的结果，并有1例早期截肢。良好的结果与准确复位相关。若仍存在轻微移位，建议行切开治疗。建议所有病例常规使用克氏针固定。
