Levy Christopher J, Yatsonsky David, Moral Muhammad Z, Liu Jiayong, Ebraheim Nabil A
College of Medicine and Life Sciences, University of Toledo, Toledo, Ohio (CJL) and Department of Orthopaedic Surgery, University of Toledo Medical Center, Toledo, Ohio.
Foot Ankle Spec. 2022 Apr;15(2):179-184. doi: 10.1177/1938640020971419. Epub 2020 Dec 3.
The purpose of this study is to determine if arthrodesis, compared with open reduction and internal fixation (ORIF), produces favorable American Orthopaedic Foot and Ankle Society (AOFAS) and visual analogue scale (VAS) scores, and to determine if differences in complication, revision surgery, and secondary arthrodesis rates exist for patients with Lisfranc fracture/dislocation injuries. Searches were performed in PubMed using the keywords "Lisfranc fracture," "metatarsal fracture," "ORIF," "open reduction internal fixation," "arthrodesis," and "fusion." These criteria left 183 articles for review. Exclusions left 21 articles and 2 translations of Chinese abstracts. Data analysis was performed using Student's 2-sample test for samples of equal variance, and chi-square test for goodness of fit. The test revealed a significant difference ( = .03) between the average AOFAS score for patients who underwent primary arthrodesis (84.7 ± 6.14) compared with those who were treated with ORIF (78.9 ± 5.09). There was no significant difference for the average VAS scores ( = .33) of the arthrodesis and ORIF groups. The complication rate of arthrodesis patients was significantly lower than ORIF patients ( = .04), and the rates of revision surgery ( = .22) and secondary arthrodesis ( = .53) were not significant between the groups. The results of this study indicate that arthrodesis may be a better surgical option than ORIF, due to the higher functional scores and the lower complication rate.Levels of Evidence: Level III: A meta-analysis.
本研究的目的是确定与切开复位内固定术（ORIF）相比，关节融合术是否能产生良好的美国矫形足踝协会（AOFAS）评分和视觉模拟量表（VAS）评分，并确定Lisfranc骨折/脱位损伤患者在并发症、翻修手术和二次关节融合率方面是否存在差异。在PubMed上使用关键词“Lisfranc骨折”“跖骨骨折”“ORIF”“切开复位内固定”“关节融合术”和“融合”进行检索。这些标准留下183篇文章以供审查。排除后剩下21篇文章和2篇中文摘要的翻译。使用方差相等样本的学生双样本t检验和拟合优度卡方检验进行数据分析。t检验显示，接受一期关节融合术的患者平均AOFAS评分（84.7±6.14）与接受ORIF治疗的患者（78.9±5.09）之间存在显著差异（P = .03）。关节融合术组和ORIF组的平均VAS评分无显著差异（P = .33）。关节融合术患者的并发症发生率显著低于ORIF患者（P = .04），两组之间的翻修手术率（P = .22）和二次关节融合率（P = .53）无显著差异。本研究结果表明，由于功能评分较高且并发症发生率较低，关节融合术可能是比ORIF更好的手术选择。证据级别：三级：荟萃分析。
