手术治疗Lisfranc关节损伤的疗效分析

发布时间：2018-03-31 17:24

本文选题：Lisfranc　切入点：损伤　出处：《浙江大学》2016年硕士论文

【摘要】：目的：Lisfranc损伤是以法国军医Jacques Lisfranc名字命名的,他首次介绍了前足严重损伤型经跗跖关节面截肢术治疗的经验,现代医学所谓的Lisfranc损伤是指跗跖关节的脱位及骨折,可为单纯的韧带损伤或涉及骨质的损伤,较为罕见,占所有损伤的0.02%,有较高的误诊率,复杂的解剖和损伤机制加大了Lisfranc损伤的诊断和治疗难度,我们通过探讨Lisfranc关节损伤的诊治方法及影响疗效的因素,以提高对该处损伤的治疗水平。方法：我们回顾性分析了自2005年2月至2013年8月收治的47例Lisfranc损伤患者,其中男36例,女11例,年龄20-63岁。对47例均采用切开复位内固定术的Lisfranc损伤患者的手术方法、疗效及并发症进行分析。根据Myerson分型A型9例、B型31例、C型7例。结果：47例随访24-48个月,平均28月,42例获得解剖复位,5例功能复位,切口感染1例,克氏针松动4例,创伤后关节炎2例。根据美国足踝矫形外科协会中足评分系统评分(AOFAS)评估疗效,优14例(29.8%),良24例(51.1%),可9例(19.1%),优良率80.9%。结论：切开复位内固定治疗Lisfranc损伤可以获得满意的的疗效,解剖复位、稳定固定是获得良好预后的关键。
[Abstract]:Objective to introduce for the first time the experience of amputation of the tarsometatarsus joint surface in the case of serious anterior foot injury named after Jacques Lisfranc, a French military doctor. The so-called Lisfranc injury in modern medicine refers to dislocation and fracture of the tarsometatarsal joint. Simple ligament injury or bone injury is rare, accounting for 0.022% of all injuries. There is a high misdiagnosis rate. The complicated anatomy and injury mechanism increase the difficulty of diagnosis and treatment of Lisfranc injury. In order to improve the treatment level of Lisfranc joint injury, we analyzed retrospectively 47 patients with Lisfranc injury from February 2005 to August 2013, including 36 males. 11 female patients, aged 20-63 years, were treated with open reduction and internal fixation for Lisfranc injury. According to the Myerson classification, there were 9 cases of type A and 31 cases of type C, 7 cases of type C. results 47 cases were followed up for 24-48 months. An average of 42 cases (28 months) received anatomic reduction in 5 cases, incision infection in 1 case, Kirschner's needle loosening in 4 cases, and post-traumatic arthritis in 2 cases. 14 cases were excellent, 24 cases were good, and 9 cases were good. The excellent and good rate was 80.9Conclusion: open reduction and internal fixation can obtain satisfactory curative effect. Anatomical reduction and stable fixation are the key to obtain good prognosis.
【学位授予单位】：浙江大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R687.4

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