跖跗关节融合治疗隐匿性Lisfranc损伤

Tarsometatarsal fusion for treatment of hidden Lisfranc injury

摘要:

[目的] 探讨跖跗关节融合术治疗隐匿性Lisfranc 损伤的临床疗效分析。[方法] 回顾性研究2010 年4 月—2020 年5月19 例隐匿性Lisfranc 损伤患者的临床资料，均行跖跗关节融合术。分析临床和影像资料。[结果] 患者均顺利完成手术，无神经、血管损伤等并发症，随访时间12~24 个月。随时间推移，VAS 评分显著减少[(5.2±1.6), (1.5±0.8), (1.1±0.7), P＜0.001]，而AOFAS 评分[(48.5±5.2), (75.8±8.7), (80.8±6.7), P＜0.001] 和SF-36 评分[(40.1±5.9), (70.7±4.0), (75.4±6.3), P＜0.001] 显著增加。影像方面，随时间推移，患足非负重位X 线片C1-M2 的间隙[(3.6±1.4), (1.2±0.2), (1.0±0.3), P＜0.001] 和M1-M2 的间隙[(4.6±1.1),(1.6±0.3), (1.4±0.4), P＜0.001] 显著减少。[结论] 跖跗关节融合术是治疗隐匿性Lisfranc 损伤的安全、有效的术式

Abstract:

[Objective] To investigate the clinical outcome of tarsometatarsal fusion in the treatment of hidden Lisfranc injury. [Methods] A retrospective study was conducted on 19 patients who had hidden Lisfranc injury treated by tarsometatarsal fusion in our hospitalfrom April 2010 to May 2020 . The clinical and imaging data were analyzed. [Results] All the patients had operation performed successful-ly without neurovascular injury and other complications, and followed up from 12 months to 24 months. The VAS score significantly re-duced [(5.2±1.6), (1.5±0.8), (1.1±0.7), P＜0.001], while the AOFAS score [(48.5±5.2), (75.8±8.7), (80.8±6.7), P＜0.001], SF-36 score [(40.1±5.9), (70.7±4.0), (75.4±6.3), P＜0.001] increased significantly over time. In terms of image, the clearance between the cuniform 1 and meta-tarsal 2 (C1-M2) in X ray of non weight bearing position [(3.6±1.4), (1.2±0.2), (1.0±0.3), P＜0.001] and the clearance of M1-M2 [(4.6±1.1),(1.6±0.3), (1.4±0.4), P＜0.001] significantly reduced with time. [Conclusion] Tarsometatarsal fusion is a safe and effective operation for hid-den Lisfranc injury,