应用Acutrak螺钉与空心螺钉治疗Lisfranc关节损伤的临床分析

Comparison of Acutrak Screw and Cannulated Screw in Surgical Treatment of Lisfranc Injury

目的探讨空心变距无头拉力螺钉（Acutrak螺钉）与空心螺钉切开复位内固定治疗Lisfranc关节损伤的临床治疗效果。方法回顾性分析2009年5月至2014年4月收治的41例Lisfranc关节损伤患者,41例患者术后均获随访,随访1~29（16±3.21）个月,根据内固定不同分为Acutrak螺钉组（n=22）,空心螺钉组（n=19）,分析两组患者术后疼痛情况、患足功能及并发症并进行美国足踝外科协会评分（American orthopaedic foot and ankle society,AOFAS）及视觉模拟评分法（visual analogue scale,VAS）评分。结果术后1个月、3个月Acutrak组VAS评分明显高于空心螺钉组（P〈0.05）,术后3月Acutrak组AOFAS评分明显高于空心螺钉组（P〈0.05）,Acutrak组术后随访中并发症少于空心螺钉组差异有统计学意义（P〉0.05）。结论应用Acutrak螺钉相比于空心螺钉切开复位内固定治疗Lisfranc关节损伤,术后有着足部功能的恢复较快、疼痛较轻,并发症相对较少的优势。

Objective To compare the clinical effect of Acutrak screw and cannulated screw in surgical treatment of Lisfranc injury. Methods We retrospectively analyzed 41 patients with Lisfranc injury from May 2009 to April 2014,who received internal fixation with Acutrak screw（ n = 22） and hollow screw（ n = 19）. They all were contrasted through postoperative complications,the ankle surgery association score（ AOFAS） and visual analogue scale（ VAS）. Results The 41 cases were followed up,with a mean period of 16 ± 3. 21（ from 1 to 29） months. The AOFAS score of Acutrak group at 1st and 6th month increased significantly than that of hollow screw group（ P〈0. 05）. The VAS score of Acutrak group at 1st and 6th month increased significantly than that of hollow screw group（ P〈0. 05）. Postoperative complications of Acutrak group was less than that of hollow screw group and the difference was significant（ P〉0. 05）. Conclusion In treatment of Lisfranc injury,Acutrak screw is superior to conventional hollow screw in terms of better recovery of postoperative feet function,less postoperative pain,and less incidence of complications.