确定 Lisfranc 损伤的手术指征:系统回顾

Foot & ankle specialist Pub Date : 2024-12-01 Epub Date: 2023-06-06 DOI:10.1177/19386400231175376
Christian Pearsall, Emily Arciero, Puneet Gupta, Henrik Bäcker, Direk Tantigate, David P Trofa, J Turner Vosseller
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引用次数: 0

摘要

目的:本综述旨在确定 Lisfranc 损伤的手术适应症:本综述旨在确定 Lisfranc 损伤的手术适应症:在适用的情况下,采用 PRISMA(系统性综述和 Meta 分析的首选报告项目)指南,使用 MEDLINE 文献检索索引 "Lisfranc 损伤 "对 1980 年以来的文献进行了系统性综述。纳入标准是通过搜索索引获得的所有报告 Lisfranc 损伤治疗的临床研究,包括病例报告、综述文章、队列研究和随机试验。非英语文章、无法访问的文章、与Lisfranc损伤治疗无关的文章(生物力学、尸体和技术文章)以及未明确说明手术适应症的文章(适应症模糊或不存在)均被排除在外:结果:在确定了 737 项研究后,对 391 项研究的全文进行了审查,最终分析纳入了 58 篇提供明确手术适应症的报告。51项(81.1%)研究提供了≥2毫米(35/58;60.4%)、≥1毫米(13;22.4%)和≥3毫米(3;5.2%)的裂隙分界线;裂隙位置最常见的是未指定(31/58;53.5%),或在跖骨、跗骨、立方体骨和楔骨组合之间变化(20/58;27.6%)。手术的具体成像标准包括撕脱骨折或斑点征(3/58;5.2%)、足弓高度下降(3/58;5.2%)以及磁共振成像显示撕裂(5;8.6%)。有 11 项(19%)研究使用 Nunley 和 Vertullo 系统(8/58;13.8%)、Myerson 系统(2;3.5%)和 Buehren 系统(1;1.7%)对手术适应症进行了分类。21项(36.2%)研究提供了多种手术适应症:结论:在有限的报告研究中,最常见的 Lisfranc 手术适应症从 1 毫米到 3 毫米不等,涉及多个部位。当务之急是提高手术适应症的报告频率和一致性,以指导这些微小损伤的临床治疗:证据等级:IV 级;系统性综述。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Defining Operative Indications in Lisfranc Injuries: A Systematic Review.

Objective: The aim of this review was to determine operative indications for Lisfranc injuries.

Methods: A systematic review using a MEDLINE literature search was performed using the index "Lisfranc Injury" from 1980 onward using PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines where applicable. Inclusion criteria were all clinical studies reporting on the management of Lisfranc injuries obtained via the search index, including case reports, review articles, cohort studies, and randomized trials. Non-English-language articles, inaccessible articles, those not relevant to the management of Lisfranc injuries (biomechanical, cadaveric, and technique articles), and those that did not explicitly state operative indications (vague or absent indications) were excluded.

Results: After identifying 737 studies, the full text of 391 studies was reviewed, and 58 reports providing explicit operative indications were included in the final analysis. Fifty-one (81.1%) studies provided diastasis cutoffs varying ≥2 mm (35/58; 60.4%), ≥1 mm (13; 22.4%), and ≥3 mm (3; 5.2%); the diastasis location was most commonly unspecified (31/58; 53.5%) or varied between combinations of metatarsal, tarsal, cuboid, and cuneiform bones (20/58; 27.6%). Specific imaging criteria for surgery included an avulsion fracture or fleck sign (3/58; 5.2%), arch height loss (3/58; 5.2%), and a tear on magnetic resonance imaging (5; 8.6%). The 11 (19%) studies defining operative indications in terms of classification schemes used the Nunley and Vertullo (8/58; 13.8%), Myerson (2; 3.5%), and Buehren (1; 1.7%) systems. Twenty-one (36.2%) studies provided multiple operative indications.

Conclusion: The most common Lisfranc operative indications among the limited reporting studies varied from a 1- to 3-mm diastasis across several locations. It is imperative for operative indications to be reported with an increased frequency and in a homogenous fashion to guide the clinical management of these subtle injuries.

Levels of evidence: Level IV; systematic Review.

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