Lisfranc损伤的早期诊断与内固定治疗

Early diagnosis and internal fixation of Lisfranc injury

目的探讨Lisfranc损伤的早期诊断要点、手术治疗原则及效果。方法分析2004年4月至2011年2月收治的23例（男17例，女6例；年龄19．0-57．0岁）Lisfranc损伤的病例资料及随访结果。所有患者均采取切开复位内固定治疗，克氏针固定13例，螺钉固定10例。按照Maryland足部评分标准进行疗效评定。结果术后21例得到随访，随访时间6．0-46．0个月，平均（28．5±2．6）个月。所有患者在末次随访时无内固定断裂、复位丢失等并发症，评分为56-97分，平均（86±8）分。其中优6例，良10例，可3例，优良率76．2％。结论对Lisfranc损伤的诊断要紧扣其早期症状和体征，结合放射学检查可以确诊。对Lisfranc损伤应采用切开复位克氏针或螺钉内固定，两种方法均可取得良好效果。

Objective To explore the main points of early diagnosis, the principles and the efficacy of surgical treatment of Lisfranc injury. Methods The clinical data and follow-up results of 23 cases of patients with Lisfrane injury treated from April 2004 to February 2011 （ 17 males, 6 females, aged from 19 to 57 years old） were collected and analyzed. All patients underwent open reduction and internal fixation, among them, 13 cases with Kirschner wire fixation and 10 cases with screws fixation. Efficacy was evaluated in accordance with Maryland foot score. Results Twenty-one patients were followed up for 6 - 46 months with an average of （ 28. 5 ± 2. 6） months. In the last follow-up no patients has internal fixation fracture,loss of reduction and other complications. The score was 56 - 97 points with an average score of （ 86 ± 8 ） points. The results showed excellent in 6 cases,good in 10 eases and fair in 3 cases,good rate was 76. 2%. Conclusion＇ Lisfranc injury can be diagnosed by early signs and symptoms, and can be confirmed by combining with radiographic examination. Lisfranc injury should be treated with open reduction and internal fixation with Kirschner wire or screw, both of the two fixation methods can achieve good results.