手术治疗Lisfranc关节损伤54例

Surgical Treatment Lisfranc Joint Injury 54 Cases

目的探讨Lisfranc关节损伤的诊治方法及影响疗效的因素。方法对54例Lisfranc损伤患者的手术方法、疗效及并发症进行分析。结果54例随访24~49个月。感染6例,克氏针松动6例,创伤后关节炎10例。依据美国矫形足踝协会（AOFAS）足评分标准对患足术后的功能进行评定。骨折脱位37例：好25例,较好10例,差2例。单纯韧带损伤17例：较好14例,差3例。结论Lisfranc损伤的解剖复位、稳定固定是获得良好预后的关键,而单纯韧带损伤远期疗效不佳。

Objective To investigate the diagnosis and treatment of Lisfranc injuries and factors that affect outcome. Methods The surgical methods,clinical effects and complications of 54 patients with Lisfranc injury were analyzed retrospectively. Results 54 cases were followed-up for 24 to 49 months. Complications were infection in 6 cases,Kirschner＇s wire loosening in 6 cases,post-traumatic arthritis in 10 cases. The postoperative function of injured foot was assessed with American Academy of Orthopedic Foot and Ankle Society （AOFAS） scoring criteria. In 37cases of fracture and dislocation,the outcome were excellent in 25 cases,good in 10 and poor in 2. In 17 cases of simplex ligamentous injury,the outcome were good in 14 cases and poor in 3. Conclusion Anatomical reduction and stable fixation are the key to obtain a good prognosis of Lisfranc injury,while the simplex ligamentous injuries have a poor long-term efficacy.