不同固定方式治疗跖跗关节损伤的疗效评价

关键词：跖跗关节 脱位及骨折脱位 螺钉固定

Keywords:tarsometatarsal joint,dislocation,fracture-dislocation,screw fixation,

摘要：

      目的：探讨跖跗关节脱位及骨折脱位的治疗方法及临床疗效。方法：对1998-2004年收治的74例跖跗关节损伤患者进行了回顾性研究，本组病例复位后分别采用石膏外固定24例、克氏针内固定22例、螺钉内同定28例。其中，单纯脱位型21例，骨折脱位型53例。结果：采用美国骨科矫形足踝协会（AOFAS）足评分标准评价随访患者的足术后功能状况，并根据不同的分型进行了优良率的比较。结论：解剖复位螺钉内固定可使跖跗关节得到长期有效的固定．取得较好的治疗效果．但是单纯脱位型较骨折脱位型预后差．

Abstract:

      Objective:To evaluate the treatment methods and clinical effect of dislocation and fracture-dislocation of tarsometatarsal joint.Method:We performed a retrospective study of patients with Lisfranc injury in a seven-year period(1998-2004). Among seventy-four patients, twenty-four were treated with plaster fixation, twenty-two with Kirschner wire fixation and twenty-eight with screw fixation. Twenty-one injuries were purely ligamentous, and fifty-three were combined ligamentous and osseous.Result:Seventy-four patients were followed for an average of eighteen months.Patient outcome was assessed with the American Orthopedic Foot and Ankle Society (AOFAS) midfoot score. Conclusion:Anatomical reduction and screw fixation of a Lisfranc injury leads to the best long-term outcomes,but purely ligamentous injuries have poor outcomes despite surgical managements.