应用逆向置入跨关节螺钉技术治疗Lisfranc关节损伤中临床疗效的观察

Application of reverse slant across the joint screw technology treatment Lisfranc joint injury in clinical curative effect observation

目的探讨治疗Lisfranc损伤中采用逆向置入跨关节螺钉技术的临床疗效。方法选取2012年5月~2017年9月收治的12例Lisfranc关节损伤,所有患者均在伤后7~12 d进行手术治疗,手术中采用逆向置入跨关节螺钉固定技术,术后定期影像学随访检查,以美国足踝外科协会(AmericanOrthopaedicFootand AnkleSociety,AOFAS)中-后足评分标准进行功能评估。结果 12例均获得随访,随访时间3~28个月,平均(21±1.3)个月,所有患者均无感染、神经损伤,无1例出现跨关节螺钉松动及断钉等并发症,按AOFAS评分由术前平均(42.5±4.6)分提高至术后平均(85.2±13.0)分。结论应用逆向打入跨关节螺钉技术治疗Lisfranc关节损伤,可以提高置钉精准度,显著降低Lisfranc关节面破裂及螺钉松动的风险。是一种值得推广的技术。

Objective To explore the clinical effect of reverse placement of transarticular screws in Lisfranc injury. Methods Between From May 2012 to September 2017, there were 12 cases of Lisfranc joint injury, all patients underwent surgical treatment 7-12 days after injury, the reverse placement of transarticular screws fixation technique was used in the operation, postoperative radiographic follow-up examination regularly, ankle surgery in the United States association （AmericanOrthopaedicFootand AnkleSociety, AOFAS）- after sufficient criteria for functional assessment.April Results 12 cases received follow-up, follow-up time （3-28 months）, Average （21±1.3） months,all patients had no infection, nerve injury, and no complications such as transarticular screws loosening and breakage, from an average （42.5±4.6） preoperatively by AOFAS score to the average of （85.2±13.4）. Conclusion The application of placement of transarticular screws technique to treat Lisfranc joint damage can improve the precision of the nail, significantly reduce the risk of fracture of Lisfranc joint and screw loose. It＇s a technology worth spreading.