Lisfranc骨折脱位的手术效果

Aditya K Medhavi, E. Venkateshulu, M. Selvan
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摘要

Lisfranc关节损伤是不常见的,在最初的评估和治疗中可能无法注意到。一旦忽视,后期复位困难,需要广泛解剖。由于残余韧带不稳定、畸形和/或关节炎,已知Lisfranc关节损伤可导致功能丧失和慢性疼痛;骨质疏松症也可因不负重的疼痛步态而发生。认识到这一点很重要,因为大多数损伤要么被误诊,要么被忽视,比如多处创伤的患者,在主要骨折愈合后可能成为永久性疼痛的来源。一项前瞻性研究将于2018年至2020年在巴拉里Vijayanagar医学科学研究所骨科进行。本研究采用空心松质螺钉联合克氏针治疗30例Lisfranc骨折脱位。根据纳入和排除标准选择病例。功能结局采用AOFAS评分进行评价。在我们的研究中,我们在10%的案例中达到优秀。73.33%的患者预后良好,13.3%的患者预后一般,无患者预后不良。平均AOFAS(美国骨科足踝评分)为76.5。本研究表明,CC(空心松质螺钉)螺钉和K针是一种基于生物力学原理的有效治疗方法,功能预后好,并发症少。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Operative outcomes of Lisfranc’s fracture dislocation
Lisfranc joint injury is uncommon and can fail to notice at the initial assessment and treatment. Once ignored, late reduction is difficult and requires extensive dissection. Lisfranc joint injuries are known to result in unctional loss and chronic pain due to residual ligamentous instability, deformity, and/or arthritis; osteoporosis may also occur due to antalgic gait without weight bearing.This recognition is important, as most of the injuries are either misdiagnosed or overlooked, such as in patients suffering from polytraumatic injuries, possibly becoming a permanent source of pain after the major fractures have healed.A prospective study to be conducted at the Department of Orthopaedic Surgery, Vijayanagar Institute of Medical Sciences, Ballari from 2018 to 2020. This study consists of 30 cases of Lisfranc’s Fracture Dislocation treated operatively by Cannulated Cancellous Screws and K wires (Kirschner Wires). The cases were selected according to inclusion and exclusion criteria. The functional outcome was evaluated using AOFAS score.In our study, we achieved Excellent in 10% of the cases. Good outcome in 73.33% of cases, Fair outcome in 13.3% of the cases and no patient had poor outcome in our study. Average AOFAS (American Orthopaedic Foot and Ankle Score) being 76.5.It can be concluded from the present study that operative management with CC (Cannulated Cancellous Screws) Screws and K Wires is an effective means of treatment based on biomechanical principle with good functional outcome and minimum complication.
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