Objective To observe the efficacy of and influencing factors for kirschner wire limited internal fixation plus external fixation for patients with tarsometatarsal fracture dislocation.
Methods The efficacy of kirschner wire limited internal fixation plus external fixation treatment for patients with tarsometatarsal fracture dislocation treated between January 2004 and June 2009 was retrospectively analyzed,and we also investigated the impact of surgery time and ligament damage on its long-term prognosis.
Results Twenty patients were included,consisting of 16 male and 4 female patients,ranging from 15 to 57 years old.The mean time of follow-up was 24.5 months,ranging from 11 to 41 months.At the time of follow-up,there were 5%(1/20),10%(2/20),50%(10/20) and 35%(7/20) patients with AOFAS ankle-hindfoot score at 0~69,70~79,80~89 and 90-100,respectively;and the excellent rate was 85% in total.In this cohort,the acceptance rate of the results of treatment was 95% at discharging and 85% at the final follow-up,and the difference between the above two time-points was not statistically significant.In addition,patients with earlier surgery treatment and lower degree of ligament injury had better long-term prognosis.
Conclusion For patients with tarsometatarsal fracture dislocation,treatment with kirschner wire limited internal fixation plus external fixation can not only effectively restore joint function,but also has minimum surgical trauma,and it is an effective method for the treatment of tarsometatarsal joint injuries.
Citation：
JIAQuan-zhong, GUHua, GOUCheng-guo. Clinical Study on Kirschner Wire Limited Internal Fixation plus External Fixation for Patients with Tarsometatarsal Fracture Dislocation. West China Medical Journal, 2014, 29(2): 259-261. doi: 10.7507/1002-0179.20140080
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Copyright © the editorial department of West China Medical Journal of West China Medical Publisher. All rights reserved
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Rammelt S,Schneiders W,Schikore H,et al.Primary open reduction and fixation compared with delayed corrective arthrodesis in the treatment of tarsometatarsal (Lisfranc) fracture dislocation[J].J Bone Joint Surg Br,2008,90(11):1499-1506.
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- 1. Jarde O,Gaffuri JG,Woestelandt T,et al.Fractures-luxations of the Lisfranc joint.Apropos of 39 cases[J].Ann Radiol (Paris),1991,34(4):278-284.
- 2. Rosenberg GA,Patterson BM.Tarsometatarsal (Lisfranc's) fracture-dislocation[J].Am J Orthop (Belle Mead NJ),1995,(Suppl):7-16.
- 3. Brinsden MD,Smith SR,Loxdale PH.Lisfranc injury-surgical fixation facilities an early return to work[J].J R Nav Med Serv,2001,87(2):116-119.
- 4. 赵敦旭.陈旧性跖跗关节脱位的足弓重建[J].中国修复重建外科杂志,2009,23(7):886-887.
- 5. 梁军,于建华.跗跖关节复合损伤的诊断和治疗[J].中华骨科杂志,2003,23(3):181-183.
- 6. 张泽坤,赵静品,吴文娟,等.跗跖关节在常规足平片中的影像学表现[J].河北医药,2011,33(7):1003-1005.
- 7. 杨茂伟,梁单,郭宝磊,等.Lisfranc损伤切开复位内固定术与关节融合术临床疗效的Meta分析[J].中国医科大学学报,2011,40(4):364-367.
- 8. Trevino SG,Kodros S.Controversies in tarsometatarsal injuries[J].Orthop Clin North Am,1995,26(2):229-238.
- 9. 蔡晓冰,纪方,王秋根,等.外固定支架结合有限内固定治疗C型跖跗关节损伤[J].中华创伤骨科杂志,2006,8(12):1188-1189.
- 10. 徐向阳,刘津浩,朱渊,等.陈旧性跖跗关节骨折脱位[J].中华创伤骨科杂志,2005,7(12):1136-1138.
- 11. Rammelt S,Schneiders W,Schikore H,et al.Primary open reduction and fixation compared with delayed corrective arthrodesis in the treatment of tarsometatarsal (Lisfranc) fracture dislocation[J].J Bone Joint Surg Br,2008,90(11):1499-1506.
