CAJ | 학술논문

目的探讨应用空心螺钉内固定治疗Lisfranc关节损伤的近期疗效.方法 2005年1月-2010年10月收治Lisfranc关节损伤患者21例,其中男14例,女7例；年龄21 ～62岁,平均38.2岁.Lisfranc关节损伤分型:单纯内侧柱损伤4例,内侧柱与中间柱损伤4例,中间柱与外侧柱损伤3例,单纯外侧柱损伤2例,三柱损伤8例.致伤原因:交通伤9例,机器伤8例,坠落伤4例.受伤至入院时间为2～15 h,平均5h,手术行切开复位空心螺钉内固定,术后定期影像学随访检查,以Maryland足部功能评分系统进行功能评估.结果 19例获得随访,平均20个月(4 ～47个月).所有患者均无感染、内固定松动或断裂等并发症.按照Maryland足部功能评分(MFS)评估疗效:优8例,良7例,可2例,差2例,优良率为79％.结论三柱重建理论对Lisfranc关节损伤的诊断和治疗有重要作用,使用空心螺钉内固定治疗Lisfranc关节损伤可以取得良好的效果.
목적 탐토응용공심라정내고정치료Lisfranc관절손상적근기료효.방법 2005년1월-2010년10월수치Lisfranc관절손상환자21례,기중남14례,녀7례；년령21 ～62세,평균38.2세.Lisfranc관절손상분형:단순내측주손상4례,내측주여중간주손상4례,중간주여외측주손상3례,단순외측주손상2례,삼주손상8례.치상원인:교통상9례,궤기상8례,추락상4례.수상지입원시간위2～15 h,평균5h,수술행절개복위공심라정내고정,술후정기영상학수방검사,이Maryland족부공능평분계통진행공능평고.결과 19례획득수방,평균20개월(4 ～47개월).소유환자균무감염、내고정송동혹단렬등병발증.안조Maryland족부공능평분(MFS)평고료효:우8례,량7례,가2례,차2례,우량솔위79％.결론 삼주중건이론대Lisfranc관절손상적진단화치료유중요작용,사용공심라정내고정치료Lisfranc관절손상가이취득량호적효과.
Objective To evaluate the preliminary outcome of cannulated screw internal fixation in treatment of the tarsometatarsal joint injuries.Methods From January 2005 to October 2010,21 patients(14 males and 7 females)with the tarsometatarsal joint injuries were treated.Their age ranged from 21 to 62 years(average 38.2 years).According to anatomical three-column classification,there were four patients with single medial column injury,four with medial and middle column injuries,three with middle and lateral column injuries,two with single lateral column injury and eight with three column injuries.The injury causes included traffic injury in nine patients,machine injury in eight and fall from height injury in four.The period from injury to admission was 2-15 hours(mean 5 hours).During operation,open reduction was performed,followed by internal fixation with the cannulated screw.X-ray examination was done in the regular follow-up and function was evaluated by using Maryland scoring system.Results Of all,19 patients were followed up for 4-47 months(mean 20 months),which showed no infection,loosing or breakage of the internal fixation.According to the Maryland scoring system,the clinical outcome was rated as excellent in eight patients,good in seven,fair in two and poor in two,with excellence rate of 79％.Conclusions The three-column theory plays an important role in clinical diagnosis and therapy of the tarsometatarsal joint injuries.Open reduction and cannulated screw internal fixation may attain satisfactory clinical results in treatment of the tarsometatarsal joint injuries.