Li Xu, Jia Le-Sheng, Li Ang, Xie Xin, Cui Jun, Li Guo-Liang
Department of Foot and Ankle Surgery, Central Hospital Affiliated to Shenyang Medical College, Shenyang 110024, Liaoning Province, China.
Department of Functional Experiment Center, Liaoning University of Traditional Chinese Medicine, Shenyang 110847, Liaoning Province, China.
World J Clin Cases. 2020 Oct 6;8(19):4388-4399. doi: 10.12998/wjcc.v8.i19.4388.
Lisfranc injuries have not received much attention by orthopedic doctors in the past, and there is little related research on the diagnosis and treatment of these injuries. In recent years with the rise in foot and ankle surgery, doctors are now paying more attention to this type of injury. However, there is still a high rate of missed diagnosis due to insufficient attention causing treatment delays or inadequate treatments, which eventually result in greater sequelae; including long-term pain, arthritis, foot deformity . In particular, for cases with a mild Lisfranc joint complex injury, the incidence of sequelae is higher.
To select an active surgical treatment for an atypical Lisfranc joint complex injury and to evaluate the clinical efficacy of the surgical treatment.
The clinical data of 18 patients, including 10 males and 8 females aged 20-64 years with Lisfranc injuries treated in our department from January 2017 to September 2019 were retrospectively analyzed. All patients were treated with an open reduction and internal fixation method using locking titanium mini-plates and hollow screws or Kirschner wires. X-ray images were taken and follow-up was performed monthly after the operation; the internal fixation was then removed 4-5 mo after the operation; and the American Orthopedic Foot and Ankle Society (AOFAS) score was used for evaluation on the last follow-up.
All patients were followed up for 6-12 mo. A good/excellent AOFAS score was observed in 88.9% of patients.
For atypical Lisfranc joint complex injuries, active open reduction and internal fixation can be performed to enable patients to obtain a good prognosis and satisfactory functional recovery.
跖跗关节损伤在过去未受到骨科医生的太多关注，关于此类损伤的诊断和治疗的相关研究较少。近年来随着足踝外科的兴起，医生们现在对此类损伤给予了更多关注。然而，由于关注不足仍存在较高的漏诊率，导致治疗延误或治疗不充分，最终产生更严重的后遗症，包括长期疼痛、关节炎、足部畸形。特别是对于轻度跖跗关节复合体损伤的病例，后遗症的发生率更高。
选择一种积极的手术治疗方法用于非典型跖跗关节复合体损伤，并评估手术治疗的临床疗效。
回顾性分析2017年1月至2019年9月在我科治疗的18例跖跗关节损伤患者的临床资料，其中男性10例，女性8例，年龄20 - 64岁。所有患者均采用锁定钛微型钢板和空心螺钉或克氏针进行切开复位内固定治疗。术后每月拍摄X线片并进行随访；术后4 - 5个月取出内固定；末次随访时采用美国足踝外科协会（AOFAS）评分进行评估。
所有患者均随访6 - 12个月。88.9%的患者获得了良好/优秀的AOFAS评分。
对于非典型跖跗关节复合体损伤，可进行积极的切开复位内固定，使患者获得良好的预后和满意的功能恢复。
