CAJ | 학술논문

目的探讨分期治疗伴有严重软组织损伤的Lisfranc骨折脱位中短期疗效。方法2009年9月至2014年3月，采用一期清创缝合，二期微型钢板、空心钉及克氏针内固定治疗伴有严重软组织损伤的Lisfranc骨折脱位患者18例，年龄22～65岁，平均（38．32±4．33）岁。根据美国足踝骨科学会（AOFAS）中足评分和疼痛视觉模拟评分（VAS）评价疗效。结果所有患者中有16例获得有效随访，平均随访（13．38±4．45）个月（6～25个月）。二期手术时间距受伤时间为（17．62±2．61）d（12～22 d），手术时间为（82．98±14．03）min（68～110 min）。所有患者骨折均一期愈合，无再次骨折及脱位发生。末次随访时AOFAS中足评分为（78．36±5．8）分（66～90分），其中优1例，良12例，可3例，优良率为81．2％，VAS评分为（2．76±0．45）分（0～6分）。结论对于伴有严重软组织损伤的Lisfranc 骨折脱位患者，采取一期消肿、清创缝合，二期钢板、空心钉及克氏针内固定治疗，疗效良好。
목적탐토분기치료반유엄중연조직손상적Lisfranc골절탈위중단기료효。방법2009년9월지2014년3월，채용일기청창봉합，이기미형강판、공심정급극씨침내고정치료반유엄중연조직손상적Lisfranc골절탈위환자18례，년령22～65세，평균（38．32±4．33）세。근거미국족과골과학회（AOFAS）중족평분화동통시각모의평분（VAS）평개료효。결과소유환자중유16례획득유효수방，평균수방（13．38±4．45）개월（6～25개월）。이기수술시간거수상시간위（17．62±2．61）d（12～22 d），수술시간위（82．98±14．03）min（68～110 min）。소유환자골절균일기유합，무재차골절급탈위발생。말차수방시AOFAS중족평분위（78．36±5．8）분（66～90분），기중우1례，량12례，가3례，우량솔위81．2％，VAS평분위（2．76±0．45）분（0～6분）。결론대우반유엄중연조직손상적Lisfranc 골절탈위환자，채취일기소종、청창봉합，이기강판、공심정급극씨침내고정치료，료효량호。
Objective To analyse the mid-term outcome of staged treatment for Lisfranc fracture-dislocation with severe soft tissue injury.Methods From September 2009 to March 2014,18 patients who were 22 to 65 years old (mean,38.32 ±4.33 years old)of Lisfranc fracture-dislocation with severe soft tissue injury were treated by staged procedure,composed of debridement in the first stage,final open reduction and internal fixation in the second stage.The clinical results were evaluated with American Orthopaedic Foot and Ankle Society (AOFAS)mid-foot score and visual analogue scale (VAS).Results Sixteen patients were followed up for 6-25 months (mean,13.38± 4.45 months).There were 12-22 days (mean,17.62 ±2.61 days)from injury to final operation.All cases were healed without nonunion and loss of reduction.At final follow-up,the AOFAS mid-foot score was 66-90 (mean, 78.36±5.8),there was excellent in 1 case,good in 12 cases,fair in 3 cases,with the excellent and good rate of 81. 2%.The VAS score was 0-6 (mean,2.76±0.45).Conclusion For Lisfranc fracture-dislocation with severe soft tissue injury,the staged treatment can yield good clinical results with less soft tissue complications.