Arntz C T, Hansen S T
Orthop Clin North Am. 1987 Jan;18(1):105-14.
Dislocations and fracture-dislocations of the tarsometatarsal joints are potentially disabling injuries that present challenging therapeutic problems. Early recognition is imperative and is based on a familiarity with the important anatomic features of this joint, mechanism of injury, and subtle radiographic changes that often accompany these lesions. Following injury, a precise anatomic reduction of the tarsometatarsal joint is critical if long-term disability is to be avoided. There appears to be a direct correlation between achieving an accurate reduction and a satisfactory clinical result. In our experience, surgical reduction offers the most effective and reliable means of achieving this goal. We have presented an approach for the management of these lesions, which we believe offers advantages over previously described techniques. Our experience has shown that accurate anatomic operative reduction and rigid internal fixation provide an increased assurance of a pain-free, durable, and functional foot in the great majority of cases.
跗跖关节脱位和骨折脱位是可能导致残疾的损伤，会带来具有挑战性的治疗问题。早期识别至关重要，这基于对该关节重要解剖特征、损伤机制以及常伴随这些损伤的细微影像学变化的熟悉程度。受伤后，若要避免长期残疾，跗跖关节的精确解剖复位至关重要。实现准确复位与满意的临床结果之间似乎存在直接关联。根据我们的经验，手术复位是实现这一目标最有效、最可靠的方法。我们介绍了一种处理这些损伤的方法，我们认为该方法比先前描述的技术具有优势。我们的经验表明，在绝大多数情况下，精确的解剖手术复位和坚强内固定能更有把握地使足部无痛、耐用且功能良好。
