手术治疗Lisfranc关节损伤临床探讨.docVIP

手术治疗Lisfranc关节损伤临床探讨 　　[摘要] 目的 探讨手术治疗Lisfranc关节损伤的临床效果分析。 方法 回顾性分析手术治疗的50例Lisfranc关节损伤患者，按Myerson分类，中柱损伤33例，内中柱损伤10例，三柱损伤7例，开放患者急诊手术7例，闭合患者43例消肿后于1周内手术。 结果 所有患者均随访半年至5年不等，平均3年，采用美国矫形足踝协会（AOFAS）评分评价术后功能情况，50例中≥90分22例，≥80分16例，≥70分7例，70分5例，平均87分，优良率90%。 结论 手术治疗Lisfranc关节损伤能够重建Lisfranc复合体的稳定性，可取得满意疗效，值得临床推广。 　　[关键词] Lisfranc损伤；外科手术；内固定；跗舟关节 　　[中图分类号] R687.3 [文献标识码] B [文章编号] 1673-9701（2016）13-0078-03 　　Observation on the clinical effect of the surgical treatment of Lisfranc injuries 　　YANG Yong SHEN Zhaoliang LIU Yijun 　　Department of Fifith Orthopaedics， the 2nd Hospital of Jinzhou City in Liaoning Province， Jinzhou 121003， China 　　[Abstract] Objective To explore the clinical effects and values of surgical treatment for Lisfranc fracture-dislocation. Methods A retrospective study was made on 50 patients with Lisfranc injuries who received surgical treatment. According to Myerson`s classification， there were 33 cases of middle column injuries， 10 cases of medial-middle column injuries and 7 cases of three-column injuries. Among them， 7 patients accepted the emergency operation and 43 cases with closed injury were treated when detumescence in average 1 week. Results All cases were followed up for 6 months to 5 years（average 3 years）. According to American Orthopaedic Foot and Ankle Society （AOFAS） evaluation scores for the 50 cases， there were 22 cases ≥90 points，16 cases≥80 points， 7 cases≥70 points， 5 cases70 points. The average score was 87 points， qualified ratio was 90%. Conclusion Lisfranc injuries can be surgically treated well and reestablish the stability of joint complex. It is worthy of extensive application because of the satisfactory effects. 　　[Key words] Lisfranc injury；Surgical operation；Internal fixation；Cymbium joint 　　Lisfranc关节又叫跖跗关节，由法国医生Jacques Lisfranc命名，是跖骨、楔骨、骰骨以及附属韧带组成的复合体，连接前足和中足[1-3]。Lisfranc关节损伤约占全身骨折的0.2%，是中足的一种严重损伤，由于其独特的解剖学特点，临床上极易漏诊，继而导致不良预后[4-6]。随着现代社会发展和交通事故、建筑事故的发生，Lisfranc关节损伤的发生率呈逐年上升趋势。我院自2009年10月～2014年10月手术治疗Lisfranc关节损伤患者