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高能Lisfranc损伤的一期关节融合术

Primary Arthrodesis for High-Energy Lisfranc Injuries.

作者信息

Godoy-Santos Alexandre Leme, de Cesar Netto Cesar

机构信息

Department of Orthopedic Surgery, Faculdade de Medicina, Universidade de São Paulo, Rua Dr Ovídio Pires de Campos 333, Cerqueira Cesar, Sao Paulo, São Paulo 05403-010, Brazil; Hospital Israelita Albert Einstein, São Paulo, São Paulo, Brazil.

Department of Orthopedics and Rehabilitation, University of Iowa, 200 Hawkins drive, Iowa City, IA 52242, USA.

出版信息

Foot Ankle Clin. 2020 Dec;25(4):727-736. doi: 10.1016/j.fcl.2020.08.010. Epub 2020 Sep 30.

Abstract

The reported incidence of Lisfranc injuries is 9.2/100.000 person-years; two-thirds of the injuries are nondisplaced. Tarsometatarsal injuries range from minor sprains and isolated ligamentous injuries to grossly unstable and multiligamentous lesions. High-energy injuries are usually linked with mechanical energy dissipation through the soft tissues. Operative treatment options include open reduction and internal fixation, open reduction with hybrid internal and external fixation, closed reduction with percutaneous internal or external fixation, and primary arthrodesis. Treatment goals are to obtain a painless, plantigrade, and stable foot. Anatomic reduction is a key factor for improved outcomes and decreased rates of post-traumatic arthritis.

摘要

据报道,Lisfranc损伤的发病率为每10万人年9.2例;其中三分之二的损伤为无移位损伤。跗跖关节损伤范围从轻微扭伤和孤立的韧带损伤到严重不稳定和多韧带损伤。高能损伤通常与机械能通过软组织消散有关。手术治疗选择包括切开复位内固定、切开复位联合内外固定、闭合复位经皮内固定或外固定以及一期关节融合术。治疗目标是获得无痛、足底着地且稳定的足部。解剖复位是改善预后和降低创伤后关节炎发生率的关键因素。

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