Maerschalk P
Unfallchirurgie. 1982 Apr;8(2):112-24. doi: 10.1007/BF02585665.
132 injuries of the Lisfranc joint were reviewed in order to show methods of diagnosis and treatment. Injuries of this joint are rare. Almost one third are open fractures and/or dislocations, mostly comminuted lesions, associated with severe soft tissue trauma and so decreasing blood supply of the foot. Most dislocations and fractures can be treated conservatively by closed reductions and following fixation by means of Kirschner wires. In cases of minimal or moderate displacement closed reduction and plaster cast proved to be sufficient. Some cases of severely dislocated fractures or fracture dislocations need open reduction. Closed reduction should never be done when it probably disrupts the blood supply and so causes ischaemia. The methods of conservative or surgical treatment should guarantee best reduction and optimal stability of weight bearing areas of the foot. Operative treatment to achieve accurate reductions does not have definite advantages over conservative methods. Open reduction is recommended in all cases of delayed treatment, if blood supply is intact and the patient is young. Inveterate cases with poor results require special shoes or an orthosis and only sometimes osteotomies and other reconstructive operations.
回顾了132例 Lisfranc 关节损伤，以展示诊断和治疗方法。该关节损伤较为罕见。几乎三分之一为开放性骨折和/或脱位，大多为粉碎性损伤，伴有严重软组织创伤，进而导致足部血供减少。大多数脱位和骨折可通过闭合复位及随后用克氏针固定进行保守治疗。对于轻度或中度移位的情况，闭合复位及石膏固定已被证明足够。一些严重脱位骨折或骨折脱位病例需要切开复位。当闭合复位可能破坏血供并导致缺血时，绝对不应进行。保守或手术治疗方法应确保足部负重区域的最佳复位和最佳稳定性。实现精确复位的手术治疗相对于保守方法并无明确优势。在所有延迟治疗的病例中，若血供完好且患者年轻，建议进行切开复位。结果不佳的陈旧病例需要特殊鞋子或矫形器，仅在某些情况下需要截骨术和其他重建手术。
