CAJ | 학술논문

目的总结分析切开复位内固定治疗早期Lisfranc关节损伤的临床经验.方法 2005-2010年共收治Lisfranc关节损伤12例,男10例,女2例;平均年龄34岁(8-60岁).Myerson分型:A型2例,B型8例,C型2例.所有患者均在伤后17 d内接受手术,手术采用切开复位、螺钉或克氏针内固定.术后采用美国足踝外科协会(American Orthopaedic Foot and Ankle Society,AOFAS)中足评分标准进行功能评估;术前、术后采用X线摄片(正、侧及左右斜位)和CT扫描进行影像学评估.结果所有患者均获得有效随访,平均随访33个月(6-60个月).术后AOFAS中足评分平均74.5分(53～96分),其中优8例,良2例,中2例.X线片和CT扫描示8例获得解剖复位.所有患者均骨性愈合.本组未见任何手术并发症.结论切开复位内固定是治疗早期Lisiranc关节损伤的有效方法,术前应结合临床、X线片和CT扫描进行综合分析.
목적 총결분석절개복위내고정치료조기Lisfranc관절손상적림상경험.방법 2005-2010년공수치Lisfranc관절손상12례,남10례,녀2례;평균년령34세(8-60세).Myerson분형:A형2례,B형8례,C형2례.소유환자균재상후17 d내접수수술,수술채용절개복위、라정혹극씨침내고정.술후채용미국족과외과협회(American Orthopaedic Foot and Ankle Society,AOFAS)중족평분표준진행공능평고;술전、술후채용X선섭편(정、측급좌우사위)화CT소묘진행영상학평고.결과 소유환자균획득유효수방,평균수방33개월(6-60개월).술후AOFAS중족평분평균74.5분(53～96분),기중우8례,량2례,중2례.X선편화CT소묘시8례획득해부복위.소유환자균골성유합.본조미견임하수술병발증.결론 절개복위내고정시치료조기Lisiranc관절손상적유효방법,술전응결합림상、X선편화CT소묘진행종합분석.
Objective To summarize the clinical experience in treatment of the Lisfranc joint injury with open reduction and internal fixation at early stage. Methods Twelve patients ( including ten males and two females at average age of 34 years) with early stage Lisfranc joint injury received open reduction and screw/wire fixation from 2005 to 2010. According to the Myerson classification, there were two patients with type A, eight with type B and two with type C. All the patients received open reduction and internal fixation with screw or Kirschner wire within 17 days after injury. The post-operative function was estimated by mid-foot scoring scale of AOFAS. X-ray and CT scan were used in radiography estimation. Results All the patients were followed up for average 33 months ( range, 6-60 months). The mean score of post-operative mid-foot scoring scale of AOFAS was 74.5 points ( range, 53-96 points), with excellent result in eight patients, good in two and fair in two. The anatomical reduction was observed in eight patients and all the patients obtained bony union according to the results of X-ray and CT scan.There was no any complication found.Conclusions Open reduction and internal fixation is a good choice for the treatment of Lisfranc joint injury at early stage. A preoperative comprehensive analysis combined with clinical X-ray and CT scan is necessary.