中国骨伤2011，Vol.24Issue(10)：869-872,4.DOI:10.3969/j.issn.1003-0034.2011.10.020
跖跗关节复合体损伤的诊治探讨
Diagnosis and treatment of tarsometatarsal joint complex injury
陈建良 1张龙君 1叶锋 1郑晓东 1王晓 1许勇1
作者信息
摘要
Abstract
Objective: To explore the diagnosis and treatment of tarsometatarsal joint complex injury (TJC). Methods: From January 2007 to January 2009,16 patients with tarsometatarsal joint complex injury were treated with open reduction and internal fixation. There were 12 males and 4 females,ranging in age from 21 to 45 years with an average of 34.1 years. Seven cases were left and 9 cases were right and all injuries caused by direct violence. Four cases caused by traffic accident 5 by fall from high and 7 by crush injury. Intereuneiform dislocation were in 1 ] cases, naviculocuneiform joint dislocation in 3 cases and cuboid fracture in 2 cases. All the cases were three column injuries. According to the situation of exploring and the stability, screw fixation was used for intertarsal joint, internal and middle column tarsometatarsal joint, the Kirschner wire fixation for external column and miniature plate fixation for comminuted fracture of metatarsal bones and compressible fracture of cuboid. The criteria of the AOFAS Foot and Ankle Surgery by the United States Association of ankle-rear foot functional scale was used to evaluate the clinical effect. Results: All the patients were followed up, the duration ranged from 6 to 18 months (averaged 12.6 months). According to the score system of AOFAS, the total score was(74.6±10.4 )points,including pain items of (29.3± 5.9) ,the score of functional items of (32.4±5.6) points, and power lines of (12.9±2.6). All the incisions were primarily healed without infection, skin necrosis, fixture broken or loosen. Three cases received arthrodesis due to osteoarthritis. Four cases were followed up continually because they only had the radiologic osteoarthritis without pain. Conclusion: Anatomical reduction and stable fixation is the key point of the treatment of tarsometatarsal joint complex injury. Open reduction and internal fixation at the first stage is good for secondary arthrodesis.关键词
跖骨/跗关节/创伤和损伤/骨折/关节融合术/骨折固定术,内Key words
Metatarsal bones/ Tarsal joints/ Wounds and injuries/ Fractures/ Arthrodesis/ Fracture fixation, internal引用本文复制引用
陈建良,张龙君,叶锋,郑晓东,王晓,许勇..跖跗关节复合体损伤的诊治探讨[J].中国骨伤,2011,24(10):869-872,4.
