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利氏损伤:治疗的最新趋势

Lisfranc Injury: Recent Trends in Management.

作者信息

Sain Arnab, Prendergast Emily, Wattage Kanishka, Elkilany Ahmed, Metry Arsany

机构信息

Orthopaedics, Worthing Hospital, University Hospitals Sussex NHS Foundation Trust, Worthing, GBR.

Orthopaedics and Trauma, Worthing Hospital, University Hospitals Sussex NHS Foundation Trust, Worthing, GBR.

出版信息

Cureus. 2023 Aug 9;15(8):e43182. doi: 10.7759/cureus.43182. eCollection 2023 Aug.

Abstract

Lisfranc injury refers to a group of bony or ligamentous injuries in which one or more of the metatarsals are displaced with respect to the tarsus. These injuries can occur as a result of either high-energy trauma like motor vehicle accidents and falls from height, or low-energy trauma from sports activities. A significant proportion of Lisfranc injuries are missed initially. The effects of delayed and missed diagnosed cases can be devastating as patients may develop progressive midfoot instability, collapse of arch, abduction of forefoot, and post-traumatic osteoarthritis, which can cause chronic pain, stiffness, and foot and ankle complex dysfunction. Favourable outcomes are associated with early diagnosis and prompt treatment. Open reduction and internal fixation (ORIF) with arthrodesis has better results than ORIF alone in functional outcomes. Dorsal bridge plates are currently the preferred mode of fixation due to advantages over trans-articular screws.

摘要

跖跗关节损伤是指一组涉及一块或多块跖骨相对于跗骨发生移位的骨或韧带损伤。这些损伤可能由高能创伤(如机动车事故和高处坠落)或体育活动中的低能创伤引起。相当一部分跖跗关节损伤最初会被漏诊。漏诊和延迟诊断的病例可能会造成严重后果,因为患者可能会出现进行性中足不稳、足弓塌陷、前足外展以及创伤后骨关节炎,进而导致慢性疼痛、僵硬以及足踝复合体功能障碍。早期诊断和及时治疗与良好的预后相关。切开复位内固定(ORIF)联合关节融合术在功能预后方面比单纯ORIF效果更好。由于相较于经关节螺钉具有优势,目前背侧桥接钢板是首选的固定方式。

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本文引用的文献

1
Updates on Lisfranc Complex Injuries.跖跗关节复合体损伤的最新进展。
Foot Ankle Orthop. 2021 Jan 25;6(1):2473011420982275. doi: 10.1177/2473011420982275. eCollection 2021 Jan.
2
Lisfranc fracture-dislocations: current management.利斯弗朗骨折脱位:当前的治疗方法
EFORT Open Rev. 2019 Jul 2;4(7):430-444. doi: 10.1302/2058-5241.4.180076. eCollection 2019 Jul.
5
Lisfranc injuries.利斯弗朗关节损伤
Curr Rev Musculoskelet Med. 2017 Mar;10(1):81-85. doi: 10.1007/s12178-017-9387-6.
10
Lisfranc injury: how frequently does it get missed? And how can we improve?
Injury. 2007 Jul;38(7):856-60. doi: 10.1016/j.injury.2006.10.002. Epub 2007 Jan 9.

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