跖跗关节骨折脱位89例

Fracture-dislocations of the tarsometatarsal joint-a report of 89 cases

目的 探讨跖跗关节骨折脱位治疗方法和疗效分析。方法 对 89例跖跗关节骨折脱位者根据分型分类法进行闭合复位石膏外固定、切开复位内固定和闭合复位内固定治疗。按跖行、稳定、疼痛、外形和X线五项标准评定临床疗效。结果 随访 6个月～ 3年 ,平均 2年。闭合复位治疗 2 9例 ,优 1 2例 ,良 1 3例 ,差 4例 ,优良率 86 %。切开复位内固定治疗 45例 ,优 2 4例 ,良 1 6例 ,差 5例 ,优良率89 %。闭合复位内固定治疗 1 5例 ,按分型统计取得满意疗效。结论 保守治疗可获满意疗效 ,手术较保守治疗并无多大优势。目前应用的分类方法 ,需进一步完善 ,对临床治疗和预后判断具有一定的指导作用。

Objective To study the method of treatment of fracture dislocations of the tarsometatarsal joint and analyse the curative effect Methods Eighty nine cases of fracture dislocation of the tarsometatarsal joint werre treated with closed reduction and plaster cast external fixation,open reduction and internal fixation,and closed reduction plus internal fixation.The final outcome was evaluated according to five standards:the walking stability soreness,the external appearance and X ray findings.Results The follow up lasted for six months to three years,average two years.29 cases of closed reduction treatment had excellent result in 12,good in 13 and poor in 4;the rate of excellent was 86%.45 cases treated with open reduction and internal fixation treatment had excellent result in 24,good in 16 and poor in 5 giving a rate of excellent result of 89%.15 cases treated with closed reduction and internal fixation,all had satisfactory results.Conclusion Conservative treatment has the satisfactory curative effect.Open reduction showed no superior results than that obtained with conservative means.