Fajardo Yelena, Maravi Fernando, Stacey Stephen, Parry Joshua
Denver Health Medical Center, Denver, USA.
Emory University, Atlanta, USA.
Eur J Orthop Surg Traumatol. 2025 Jun 3;35(1):230. doi: 10.1007/s00590-025-04367-5.
To evaluate for associations with loss or reduction (LOR) after fixation of Lisfranc joint injuries (LFJI). The secondary purpose was to compare 4.0 mm partially-threaded cannulated (4.0 PTC) and 3.5 mm fully-threaded solid (3.5 FTS) screw fixation.
A retrospective comparative study at 2 level-one trauma centers was performed to evaluate patients with screw-only fixation of LFJI. Patient, injury, and screw fixation variables were collected. Associations with LOR were evaluated. Fixation with 4.0 PTC versus 3.5 FTS screws was compared in terms of LOR, screw breakage, and symptomatic screw removal.
There were 78 patients included. The median age was 37.5 years (IQR 26.7-51.0) and 59.0% (n = 46) were male. The median follow-up was 6.7 months (IQR 3.8-14.3). Patients that had a LOR, versus those that did not, had a similar proportion of cannulated screws (57.1% vs. 40.6%, p = 0.26), 3.5 mm diameter screws (57.1% vs. 64.1%), fully-threaded screws (64.3% vs. 67.2%, p = 0.75), and antegrade (vs. retrograde) LFJ screws (78.6% vs. 59.4%, p = 0.32). The groups did not differ in age, Body Mass Index, high-energy mechanisms, joints fixed, or weeks to full weight bearing (p > 0.05). Fixation with 4.0 PTC (n = 26) versus 3.5 FTS screws (n = 43), did not differ in LOR (19.2% vs. 14.0%, p = 0.53), screw breakage (3.8% vs. 18.6%, p = 0.09), or symptomatic screw removals (19.2% vs. 18.6%, p = 0.88).
LOR was not associated with any of the variables analyzed. Fixation with 4.0 PTC versus 3.5 FTS screws had similar rates of LOR, screw breakage, and symptomatic implant removal.
Diagnostic Level III.
评估Lisfranc关节损伤（LFJI）固定术后与丢失或复位不良（LOR）相关的因素。次要目的是比较4.0毫米半螺纹空心（4.0 PTC）螺钉和3.5毫米全螺纹实心（3.5 FTS）螺钉固定。
在2个一级创伤中心进行了一项回顾性比较研究，以评估仅采用螺钉固定的LFJI患者。收集患者、损伤和螺钉固定变量。评估与LOR相关的因素。比较4.0 PTC螺钉与3.5 FTS螺钉在LOR、螺钉断裂和有症状的螺钉取出方面的差异。
共纳入78例患者。中位年龄为37.5岁（四分位间距26.7 - 51.0），59.0%（n = 46）为男性。中位随访时间为6.7个月（四分位间距3.8 - 14.3）。发生LOR的患者与未发生LOR的患者相比，空心螺钉的比例相似（57.1%对40.6%，p = 0.26），直径3.5毫米螺钉的比例（57.1%对64.1%），全螺纹螺钉的比例（64.3%对67.2%，p = 0.75），以及顺行（对逆行）LFJ螺钉的比例（78.6%对59.4%，p = 0.32）。两组在年龄、体重指数、高能量损伤机制、固定的关节或完全负重的周数方面无差异（p > 0.05）。4.0 PTC螺钉（n = 26）与3.5 FTS螺钉（n = 43）固定在LOR（19.2%对14.0%，p = 0.53）、螺钉断裂（3.8%对18.6%，p = 0.09）或有症状的螺钉取出（19.2%对18.6%，p = 0.88）方面无差异。
LOR与所分析的任何变量均无关联。4. O PTC螺钉与3.5 FTS螺钉固定在LOR、螺钉断裂和有症状的植入物取出率方面相似。
诊断性三级。
