切开复位钢板联合克氏针内固定治疗Lisfranc损伤

Open reduction plate combined with Kirschner wire internal fixation in treatment of Lisfranc injury

目的 探讨Lisfranc损伤应用切开复位钢板联合克氏针内固定方法治疗的临床效果。方法 2015年12月-2021年3月共收治Lisfranc损伤患者11例,应用切开复位钢板联合克氏针内固定方法治疗。所有患者均消肿后择期手术,术后行AOFAS评分评定疗效。结果 术后患者均获随访,随访时间4个月~5年,平均1.5年,AOFAS评分61~97分,平均83.5分,优良率为82.3%。术后1例切口边缘皮肤坏死,换药后愈合;1例发生创伤性关节炎。切口无感染,均一期愈合;脱位完全复位,3~4个月后复查骨折愈合良好。结论 切开解剖复位,钢板联合克氏针固定相对稳定,符合Lisfranc力学原理,该手术方法治疗Lisfranc损伤临床效果满意。

Objective To investigate the clinical effect of open reduction plate combined with Kirschner wire internal fixation in the treatment of Lisfranc injury. Methods From December 2015 to March 2021,11 patients with Lisfranc injury were treated with open reduction plate combined with Kirschner wire internal fixation. All patients underwent selective surgery after apocatastasis. Postoperative AOFAS score was used to evaluate the curative effect. Results All patients were followed up for 4 months to 5 years,with an average follow-up of 1.5 years, the AOFAS score was 61 ~97 points, with an average of 83.5points, the excellent and good rate was 82.3%. One case had skin necrosis at the edge of incision and healed after dressing change. Traumatic arthritis occurred in 1 case. The dislocation was completely reduced and the fracture healed in one stage. 11 cases had no infection and no bone nonunion.Conclusion Open anatomical reduction, Steel plate combined Kirschner wire relatively stable fixation is in accordance with Lisfranc’s mechanical principle, the clinical effect of this surgical method in the treatment of Lisfranc injury is satisfactory.