跨关节钢板内固定治疗Lisfranc损伤临床研究.docVIP

跨关节钢板内固定治疗Lisfranc损伤临床研究 　　[摘要] 目的 ?结切开复位跨关节钢板内固定治疗Lisfranc损伤的临床经验。 方法 自2012年4月～2016年4月期间，我院共收治24例Lisfranc关节损伤的患者，男14例，女10例，平均年龄42.6岁，损伤按Myerson分型：A型 5例；B型 11例；C型 8例。所有患者待足部软组织条件改善后，择期行切开复位跨关节钢板内固定术。术后定期放射学检查随访，采用美国矫形外科足踝协会（AOFAS）足评分进行治疗效果评价，并记录相关并发症。 结果 24例患者术后平均随访22个月（6～36个月），随访期间未见伤口感染、皮肤坏死等软组织并发症，1例患者术后8个月复查时发现钢板断裂，但无不适主诉，予以取出内固定。1例患者术后13个月继发创伤性关节炎，出现明显疼痛伴行走困难，保守治疗无效，予行跖跗关节融合术。X线片示术后平均12周（10～16周）骨性愈合。根据AOFAS足评分标准进行。结果显示：好（80分）11例，较好（60～80分）9例，差（60分）4例。 结论用切开复位跨关节钢板内固定治疗Lisfranc关节损伤，可避免贯穿跖跗关节固定，减少关节软骨继发损伤，可以取得良好的临床效果。 　　[关键词] 足损伤；骨折固定术；锁定钢板；跖跗关节 　　[中图分类号] R683.1 [文献标识码] B [文章编号] 1673-9701（2017）18-0069-04 　　Clinical study on cross-joint plate internal fixation in the treatment of lisfranc injury 　　HU Wenlin ZHU Jianxiang TANG Huibin XIA Zengbing 　　Department of Orthopedics， Huzhou First People’s Hospital of Zhejiang Province， Huzhou 313000， China 　　[Abstract] Objective To summarize the clinical experience of open reduction and cross-joint plate internal fixation in the treatment of lisfranc injury. Methods a total of 24 patients with lisfranc joint injury from April 2012 to April 2016 were admitted to our hospital. There were 14 males and 10 females with an average age of 42.6 years. Injury was classified by Myerson classification： 5 cases of type A； 11 cases of type B； 8 cases of type C. All patients were given selective surgery of open reduction and cross-joint plate internal fixation after the improvement of the condition of foot soft tissues. Postoperative radiological follow-up was carried out regularly. The evaluation of the therapeutic effect was performed using the foot scores of the American Orthopaedic Foot and Ankle Society（AOFAS）， and related complications were recorded. Results 24 patients were followed up for an average of 22 months （6 to 36 months） after the surgery. No wound infection， skin necrosis and other soft tissue complications were observed during follow-up period. The re-examination in 1 case 8 months after the surgery found that t