文章摘要
黄健华,包朝鲁,李 业,彭 程,吴小建.克氏针、螺钉及微型钢板内固定治疗Lisfranc损伤的风险及疗效观察[J].,2020,(9):1773-1777
克氏针、螺钉及微型钢板内固定治疗Lisfranc损伤的风险及疗效观察
The Risk and Efficacy of Kirschner Wire, Screw and Mini Plate Internal Fixation in the Treatment of Lisfranc Injury
投稿时间:2020-01-04  修订日期:2020-01-27
DOI:10.13241/j.cnki.pmb.2020.09.038
中文关键词: Lisfranc损伤  克氏针  螺钉  微型钢板内固定  关节功能
英文关键词: Lisfranc injury  Kirschner wire  Screw  Mini plate internal fixation  Joint function
基金项目:上海市科学技术委员会科研计划项目(14ZR1408600)
作者单位E-mail
黄健华 上海中医药大学附属曙光医院宝山分院骨科 上海201900 wangxiys@163.com 
包朝鲁 上海中医药大学附属曙光医院宝山分院骨科 上海201900  
李 业 上海中医药大学附属曙光医院宝山分院骨科 上海201900  
彭 程 上海中医药大学附属曙光医院宝山分院骨科 上海201900  
吴小建 上海中医药大学附属曙光医院宝山分院骨科 上海201900  
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中文摘要:
      摘要 目的:探讨克氏针、螺钉及微型钢板内固定治疗Lisfranc损伤的风险及疗效观察。方法:选择2013年2月至2018年3月我院接诊的108例Lisfranc损伤患者进行前瞻性分析,通过不同的手术方案分为a组34例,b组36例,c组38例,其中a组采用克氏针固定治疗,b组采用空心螺钉固定治疗,c组采用微型钢板内固定治疗。比较三组患者的围手术期情况、视觉模拟疼痛评分(VAS)、日常生活能力量表(ADL)、踝-后足评分系统(AOFAS)评分、足踝功能优良率和术后并发症情况,三组患者均在术后到医院门诊进行复查。结果:c组手术时间长于a组、b组,b组手术时间长于c组(P<0.05),c组骨折愈合时间短于a组、b组螺钉,b组骨折愈合时间长于a组(P<0.05);c组术后2周、8周时VAS评分均明显低于a组和b组,b组VAS评分明显低于a组(P<0.05);术后12个月时,c组ADL评分、AOFAS评分、足踝功能优良率均高于a组、b组,b组ADL评分、AOFAS评分、足踝功能优良率明显高于a组(P<0.05);三组患者术后并发症的总发生率差异无统计学意义(P>0.05)。结论:微型钢板内固定治疗Lisfranc损伤能有效减轻患者疼痛,促进骨折愈合及足踝功能恢复,值得临床推广应用。
英文摘要:
      ABSTRACT Objective: To study the risk and efficacy of Kirschner wire, screw and mini plate internal fixation in the treatment of Lisfranc injury. Methods: A total of 108 patients with Lisfranc injury who were admitted to our hospital from February 2013 to March 2018 were selected for research conduct prospective analysis. They were divided into 34 cases in the a group, 36 cases in the b group, 38 cases in the c group. The a group was treated with kirschner wire fixation, the b group was treated with cannulated screws, and the c group was treated with mini-plate internal fixation. The perioperative situation, visual simulated pain score (VAS), activity of daily living scale (ADL), ankle-hindfoot scoring system (AOFAS) score, the excellent ankle function rate and postoperative complications of the three groups were compared, the three groups were reexamined in the outpatient department of the hospital. Results: The operation time in the c group was longer than that of the a group and b group, and peration time in the b groups was longer than that of the a group(P<0.05); the healing time in the c group was shorter than that of the a group and b group, and healing time in the b groups was longer than that of the a group(P<0.05); the VAS score in the c group was significantly lower than that of the a group and b group at after operation 2 and 8 weeks, and VAS score in the b groups was lower than that of the a group(P<0.05); at after operation 12 months, ADL scores, AOFAS score and excellent ankle function ratein the c group was significantly higer than that of the a group and b group, the ADL scores, AOFAS score and excellent ankle function ratein in the b groups was higher than that of the a group(P<0.05); there was no significant difference in the total incidence of postoperative complications among the three groups(P>0.05). Conclusion: Mini plate internal fixation can effectively reduce the pain of patients with Lisfranc injury, promote fracture healing and ankle function recovery, which is worthy of clinical application.
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