微型锁定加压钢板结合克氏针内固定治疗Lisfranc关节三柱损伤

发布时间：2018-11-17 08:04

【摘要】：[目的]探讨切开复位微型锁定加压钢板(LCP)结合克氏针内固定治疗Lisfranc关节三柱损伤的疗效及治疗体会。[方法]自2011年6月~2014年12月本院共收治12例12足Lisfranc关节三柱损伤患者,按Myerson分类:A型8例,C2型4例,均行切开复位内固定治疗,应用微型LCP结合克氏针内固定治疗,术后观察并发症发生情况,定期放射学检查随诊,以美国足踝外科协会AOFAS评分系统和疼痛视觉模拟评分(VAS)进行功能评估。[结果]12例患者全部获得随访,随访时间12~24个月,平均18个月。术后患者均未发生切口感染、皮肤坏死、骨筋膜室综合征及内固定失效等并发症,2例于末次随访时出现骨性关节炎表现,行走疼痛,1例较轻,1例需口服止痛药物,均不影响日常生活。末次随访AOFAS总评分(83.4±8.1)分,优4例,良6例,可2例,优良率为83.3%。VSA评分为0~6分,平均(2.5±0.7)分。[结论]切开复位应用微型LCP结合克氏针内固定治疗Lisfranc关节三柱损伤,能使跖跗关节解剖复位,固定确切,术后并发症少,临床疗效满意。
[Abstract]:[objective] to investigate the effect and experience of open reduction and mini-locking compression plate (LCP) combined with Kirschner's needle fixation in the treatment of Lisfranc joint triple-column injury. [methods] from June 2011 to December 2014, 12 patients with three-column injury of Lisfranc joint were treated in our hospital. According to the classification of Myerson, 8 cases of type A and 4 cases of type C2 were treated with open reduction and internal fixation, and treated with mini-LCP combined with Kirschner's needle internal fixation. Postoperative complications were observed, followed up by regular radiologic examinations, and the function was evaluated by the American Association of foot and ankle Surgical Association AOFAS scoring system and the pain Visual Analog scale (VAS). [results] all 12 patients were followed up for 12 ~ 24 months (mean 18 months). There were no complications such as incision infection, skin necrosis, osseous fascia syndrome and failure of internal fixation in all the patients. 2 cases had osteoarthritis and walking pain at the last follow-up, 1 case was mild, and 1 case needed oral analgesic drugs. Does not affect daily life. At the last follow-up, the total score of AOFAS was (83.4 卤8.1), excellent in 4 cases, good in 6 cases and fair in 2 cases. The excellent and good rate was 0 ~ 6 points in 83.3%.VSA score with an average of (2.5 卤0.7) points. [conclusion] Open reduction with mini-LCP combined with Kirschner's needle internal fixation for Lisfranc joint triple-column injury can make the tarsometatarsal joint anatomical reduction, fixation, less postoperative complications and satisfactory clinical effect.
【作者单位】：山东省潍坊市人民医院手足骨外科;
【分类号】：R687.3

【相似文献】