Wunder Johannes, Schirdewahn Christoph, Griger David, Schnabl Matthias, von Rüden Christian
Klinik für Unfallchirurgie, Orthopädie und Handchirurgie, Klinikum Weiden, Söllnerstr. 16, 92637, Weiden in der Oberpfalz, Deutschland.
Institut für Biomechanik, Paracelsus Medizinische Privatuniversität, Salzburg, Österreich.
Unfallchirurgie (Heidelb). 2024 Sep;127(9):665-676. doi: 10.1007/s00113-024-01467-5. Epub 2024 Jul 30.
Lisfranc injuries are rare but severe injuries of the foot. They range from ligament sprain to complex fracture dislocations. Etiologically, a distinction is made between indirect and direct force and between high-energy and low-energy trauma. Inadequate diagnostics (injuries overlooked or misinterpreted) can lead to painful posttraumatic osteoarthritis, chronic instability and deformity of the foot. A fracture, malalignment and unclear findings in conventional radiological diagnostics necessitate computed tomography imaging including 3D reconstruction. Lisfranc injuries are often associated with accompanying pathologies of the foot that also need to be addressed. Only stable non-displaced fractures can be treated conservatively. Depending on the injury pattern, surgical treatment is performed percutaneously, minimally invasive or open. The prognosis following Lisfranc injury is determined by the severity of damage and the quality of reconstruction.
利氏损伤是足部罕见但严重的损伤。其范围从韧带扭伤到复杂的骨折脱位。从病因学上看，可分为间接和直接暴力，以及高能和低能创伤。诊断不充分（损伤被忽视或误判）会导致创伤后疼痛性骨关节炎、足部慢性不稳定和畸形。传统放射学诊断中的骨折、排列不齐和不明确的结果需要进行包括三维重建的计算机断层扫描成像。利氏损伤常伴有足部的其他病变，也需要进行处理。只有稳定的无移位骨折可以保守治疗。根据损伤类型，手术治疗可采用经皮、微创或开放手术。利氏损伤后的预后取决于损伤的严重程度和重建的质量。
