微型钛板联合空心钉治疗Myerson B～C型Lisfranc损伤的临床应用

Clinical Application in Fixing with Titanium Miniplate and Cannulated Screw for Treatment to Myerson Type B～C Lisfranc's Joint Injuries

目的探讨微型钛板联合空心钉"四边形"固定治疗Myerson B^C型Lisfranc损伤的方法与疗效。方法2012年8月至2014年6月,采用微型钢板联合空心钉"四边形"固定治疗12例Myerson分型B型及C型Lisfranc损伤患者,年龄21~53岁,平均24.5岁,其中B1型4例,B2型5例,C1型2例,C2型1例。根据美国足踝外科协会(American orthopaedic foot and ankle society,AOFAS)踝-后足评分评价效果。结果术后12例获得6~48个月随访,平均随访时间21个月。X线片显示12例足均获得解剖复位,足弓形态恢复正常。所有骨折均一期愈合,末次随访时AOFAS评分平均76.3分。结果优(90~100分)4例,良(80~89分)6例,可(70~79分)2例,优良率为86%。结论应用微型钛板联合空心钉"四边形"固定技术治疗Lisfranc损伤可以取得良好的效果。

Objective To evaluate the efficacy of＂Quadrilateral＂in fixing with titanium miniplate and cannulate screw for treatment to myerson type B ~ C lisfranc＇s joint injuries. Methods From August 2012 to June 2014. 12 patients of 21 to 50 years old（ mean 24. 5 years old）,with lisfranc joint injuries were treated by open reduction and＂Quadrilateral＂in fixing with titanium miniplate and cannulate screw. According to myerson classification,there were 4 cases of type B1,5 cases of type B2,3cases of type C1,1 cases of type C2. American Orthopaedic Foot and Ankle Socciety（ AOFAS） ankle-hindfoot scale were used for the outcome measurement at the final follow-up. Results All patients were followed up for 6 ~ 48 months（ mean 21 months）. X-ray showed anatomicl reduction. Normal foot arches were achieved. All fractures healed. At the last follow-up. AOFAS score was 76. 3points in average. There were excellent results in 4 cases,good in 6 cases,fair in 2 cases,with an excellent and good rate of 86%. Conclusion ＂Quadrilateral＂fixation with titanium miniplate and cannulate screw can attain satisfactory clinical results in treatment of the Lisfranc＇s joint injuries.