Mantas J P, Burks R T
Division of Orthopedic Surgery, University of Utah School of Medicine, Salt Lake City.
Clin Sports Med. 1994 Oct;13(4):719-30.
Injuries to the Lisfranc joint in the athlete comprise a very small proportion of tarsometatarsal injuries and are unique in several different ways. The energy involved appears to be on a much smaller order of magnitude than more commonly encountered injuries leading to obvious fracture and dislocation. Second metatarsal subluxation with diastasis between the first and second metatarsal tends to be the most commonly encountered injury; however, the true extent of injury cannot be based solely on the amount of diastasis present. Lateral weight-bearing radiographs facilitate evaluation of the normal medial cuneiform-fifth metatarsal relationship, which when disrupted indicates an injury more significant than a simple sprain and the possible need for open reduction and internal fixation. Finally, the restoration of this normal radiographic relationship between the medial cuneiform and fifth metatarsal on lateral weight-bearing views correlates well with the prognosis for achieving an asymptomatic, well-functioning foot, allowing a return to a competitive level of athletic participation.
运动员中 Lisfranc 关节损伤在跗跖关节损伤中占比极小，且在多个方面具有独特性。与更常见的导致明显骨折和脱位的损伤相比，其所涉及的能量似乎要小得多。第二跖骨半脱位且第一和第二跖骨间出现分离往往是最常见的损伤；然而，损伤的真实程度不能仅基于现有的分离量来判断。负重位外侧 X 线片有助于评估正常的内侧楔骨与第五跖骨的关系，当这种关系中断时，表明损伤比单纯扭伤更严重，可能需要切开复位内固定。最后，在负重位外侧视图上内侧楔骨与第五跖骨之间这种正常影像学关系的恢复与实现无症状、功能良好的足部预后密切相关，从而能够恢复到竞技水平的运动参与。
