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Tightrope 系统治疗单纯韧带型 Lisfranc 损伤的临床疗效。

Clinical outcomes of Tightrope system in the treatment of purely ligamentous Lisfranc injuries.

机构信息

Department of Orthopaedic Surgery, Anhui Spinal Deformity and Clinical Medical Research Center, Fuyang Hospital Affiliated to Anhui Medical University, Fuyang People's Hospital, Fuyang, 236000, Anhui, People's Republic of China.

出版信息

BMC Surg. 2021 Nov 7;21(1):395. doi: 10.1186/s12893-021-01394-x.

Abstract

BACKGROUND

Purely ligamentous Lisfranc injuries are mainly caused by low energy damage and often require surgical treatment. There are several operative techniques for rigid fixation to solve this problem clinically. This study evaluated the effect of using the Tightrope system to reconstruct the Lisfranc ligament for elastic fixation.

METHODS

We retrospectively analyzed 11 cases with purely ligamentous Lisfranc injuries treated with the Tightrope system from 2016 to 2019, including 8 male and 3 female. X-ray was performed regularly after operation to measure the distance between the first and second metatarsal joint and the visual analogue scale (VAS) score was used to evaluate pain relief. American orthopedic foot & ankle society (AOFAS) and Maryland foot score were recorded at the last follow-up.

RESULTS

The average follow-up time was 20.5 months (range, 17-24). There was statistically significant difference in the distance between the first and second metatarsal joint and VAS score at 3 months, 6 months, and the last follow-up when compared with preoperative values (P < 0.05).Mean of postoperative AOFAS mid-foot scale and Maryland foot score were 92.4 ± 4.3, 94.1 ± 3.5, respectively. The Tightrope system was not removed and the foot obtained better biomechanical stability. No complications occurred during the operation.

CONCLUSION

Tightrope system in the treatment of purely ligamentous Lisfranc injuries can stabilize the tarsometatarsal joint and achieve satisfactory effect.

摘要

背景

单纯性跖跗关节韧带损伤主要由低能量损伤引起,常需手术治疗。临床上有多种刚性固定的手术技术可用于解决这个问题。本研究评估了使用 Tightrope 系统重建跖跗韧带进行弹性固定的效果。

方法

我们回顾性分析了 2016 年至 2019 年间采用 Tightrope 系统治疗的 11 例单纯性跖跗关节韧带损伤患者,其中男 8 例,女 3 例。术后定期行 X 线检查,测量第一、二跖骨间的距离,并采用视觉模拟评分(VAS)评估疼痛缓解情况。末次随访时记录美国矫形足踝协会(AOFAS)和马里兰足部评分。

结果

平均随访时间为 20.5 个月(范围 17-24 个月)。与术前相比,术后 3 个月、6 个月和末次随访时第一、二跖骨间的距离和 VAS 评分均有统计学差异(P < 0.05)。术后 AOFAS 中足评分和 Maryland 足部评分分别为 92.4 ± 4.3、94.1 ± 3.5。Tightrope 系统未取出,足部获得了更好的生物力学稳定性。手术过程中无并发症发生。

结论

Tightrope 系统治疗单纯性跖跗关节韧带损伤可稳定跗跖关节,取得满意效果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9276/8573989/72986d418631/12893_2021_1394_Fig1_HTML.jpg

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