Petje G, Schiller C, Steinböck G
Department für Fusschirurgie I/D, Orthopädisches Spital Speising, Wien.
Unfallchirurg. 1997 Oct;100(10):787-91. doi: 10.1007/s001130050194.
In this retrospective study, 13 patients with subtle Lisfranc joint injuries were examined after a mean period of 23 months using clinical assessment, radiography and dynamic pedographic gait analysis. The aims were to identify the factors leading to a mobile flatfoot deformity, evaluate the functional and clinical outcome of these injuries, and draw practical conclusions for initial management and subsequent intervention. All patients showed a mobile flatfoot deformity, increased motion in the subtalar joint, increased load on the hindfoot, decreased load on the forefoot, and a prolonged contact phase during the stance phase. Radiographs revealed progressive osteoarthrosis in the joint and a residual displacement of the medial Lisfranc joint. An unstable medial Lisfranc joint results in the development of a mobile flatfoot. Initial treatment of a subtly displaced Lisfranc joint should consist of exact anatomical reduction and additional maintenance of the longitudinal arch of the foot. After failed initial treatment, early arthrodesis of the midfoot is recommended as a salvage procedure for the foot.
在这项回顾性研究中，对13例Lisfranc关节细微损伤患者在平均23个月后进行了检查，采用临床评估、放射学检查和动态足 pedographic步态分析。目的是确定导致可动性平足畸形的因素，评估这些损伤的功能和临床结果，并得出关于初始治疗和后续干预的实际结论。所有患者均表现出可动性平足畸形、距下关节活动增加、后足负荷增加、前足负荷减少以及站立期接触阶段延长。X线片显示关节出现进行性骨关节炎以及内侧Lisfranc关节残留移位。内侧Lisfranc关节不稳定会导致可动性平足的发展。对于细微移位的Lisfranc关节，初始治疗应包括精确的解剖复位以及额外维持足的纵弓。初始治疗失败后，建议早期进行中足关节融合术作为足部的挽救手术。
