切开复位克氏针经皮固定治疗Chopart关节脱位的短期疗效分析
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摘要
目的 :探讨切开复位克氏针经皮固定治疗Chopart关节脱位的短期临床疗效。方法:自2014年8月至2017年8月,采用切开复位克氏针经皮固定治疗13例Chopart关节脱位患者,男7例,女6例;年龄13～58岁。术后12个月采用美国足踝矫形外科协会(AOFAS)中足评分及视觉模拟评分(VAS)进行疗效评价。结果:所有患者获得随访,时间8～24个月。术后12个月AOFAS评分65～99;优8例,良4例,可1例;VAS评分0～4。所有切口Ⅰ期愈合,愈合时间12～16 d。术后未见皮肤坏死、感染、克氏针断裂等并发症,1例术后4周出现克氏针松动。结论:切开复位结合克氏针内固定对于Chopart关节脱位能明显缓解疼痛,改善功能活动,短期满意疗效。
Objective:To investigate short-term clinical efficacy of open reduction and percutaneous Kirschner wire fixation for Chopart joint dislocation. Methods:From August 2014 to August 2017,13 patients with Chopart joint dislocation were treated by open reduction and percutaneous Kirschner wire fixation,including 7 males and 6 female aged from 13 to 58 years old. American Orthopaedic Foot and Ankle Society(AOFAS)criteria system and visual analogue scale(VAS) were applied to evaluate function of foot and ankle at 12 months after operation. Results:All patients were followed up from 8 to 24 months.AOFAS score at 12 months after operation ranged from 65 to 99;8 cases got excellent results,4 good and 1 moderate. VAS score ranged from 0 to 4. All wounds were primary healed from 12 to 16 days,and no skin necrosis,infection,Kirschner broken,or other complications occurred. One patient occurred Kirschner's wire loosening at 4 weeks after operation. Conclusion:Open reduction and percutaneous Kirschner wire fixation for Chopart joint dislocation could relieve pain and improve functional activities and obtain satisfactory short term clinical results.
Objective:To investigate short-term clinical efficacy of open reduction and percutaneous Kirschner wire fixation for Chopart joint dislocation. Methods:From August 2014 to August 2017,13 patients with Chopart joint dislocation were treated by open reduction and percutaneous Kirschner wire fixation,including 7 males and 6 female aged from 13 to 58 years old. American Orthopaedic Foot and Ankle Society(AOFAS)criteria system and visual analogue scale(VAS) were applied to evaluate function of foot and ankle at 12 months after operation. Results:All patients were followed up from 8 to 24 months.AOFAS score at 12 months after operation ranged from 65 to 99;8 cases got excellent results,4 good and 1 moderate. VAS score ranged from 0 to 4. All wounds were primary healed from 12 to 16 days,and no skin necrosis,infection,Kirschner broken,or other complications occurred. One patient occurred Kirschner's wire loosening at 4 weeks after operation. Conclusion:Open reduction and percutaneous Kirschner wire fixation for Chopart joint dislocation could relieve pain and improve functional activities and obtain satisfactory short term clinical results.
引文
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[2] Harris AP,Johnson J,Waryasz GR. Isolated dorsal dislocations of the talonavicular and calcaneocuboid articulations(Chopart joints)from a low-energy mechanism[J]. Am J Emerg Med,2016,34(8):1733.
[3] Main BJ,Jowett RL. Injuries of the midtarsal joint[J]. J Bone Joint Surg Br,1975,57:89-97.
[4] Sayyed Hosseinian SH,Hassankhani GG,Bagheri F,et al. Validation of the persian version of the American Orthopedic Foot and Ankle Society Score(AOFAS)Questionnaire[J]. Arch Bone Jt Surg,2018, 6(3):233-239.
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[11]鲁强,王平凡.多层螺旋CT后处理技术在足骨骨折诊断中的应用[J].山东医药,2009,49(3):43-44.LU Q,WANG PF. Application of post-processing technique of multi slice spiral CT in diagnosis of fracture of foot bone[J]. Shan Dong Yi Yao,2009,49(3):43-44. Chinese.
[12] Harrasser N,Gradl G. Mid foot fractures of the chopart and lisfranc joint line[J]. MMW Fortschr Med,2014,156(8):54-55.
[13] Walter WR,Hirschmann A,Alaia EF,et al. Journal club:MRI evaluation of midtarsal(Chopart)sprain in the setting of acute ankle injury[J]. AJR Am J Roentgenol,2018,210(2):386-395.
[14] Tafur M,Rosenberg ZS,Bencardino JT. MR imaging of the midfoot includingChopart and lisfranc joint complexes[J]. Magn Reson Imaging Clin N Am,2017,25(1):95-125.
[15]华强,赵慧毅,陈刚,等. Chopart关节损伤的手术治疗方法与疗效观察[J].中国骨与关节损伤杂志,2015,30(10):1114-1116.HUA Q,ZHAO HY,CHEN G,et al. Chopart surgical treatment of joint injury and curative effect observation[J]. Zhongguo Gu Yu Guan Jie Sun Shang Za Zhi,2015,30(10):1114-1116. Chinese.
[16]黄杰烽,郑杨,陈星,等.伴第2跖骨基底部粉碎的Lisfranc损伤的手术治疗[J].中国骨伤,2015,28(2):171-173.HUANG JF,ZHENG Y,CHEN X,et al. Surgical treatment for Lisfranc injuries accompanied by the base crashing of the second metatarsal bone[J]. Zhongguo Gu Shang/China J Orthop Trmuma,2015,28(2):171-173. Chinese with abtstract in English.
[17]俞光荣,洪浩.踝关节损伤的治疗进展与思考[J].中国骨伤,2016,29(12):1071-1073.YU GR,HONG H. Development and think about ankle joint injury[J]. Zhongguo Gu Shang/China J Orthop Trmuma,2016,29(12):1071-1073. Chinese.
[2] Harris AP,Johnson J,Waryasz GR. Isolated dorsal dislocations of the talonavicular and calcaneocuboid articulations(Chopart joints)from a low-energy mechanism[J]. Am J Emerg Med,2016,34(8):1733.
[3] Main BJ,Jowett RL. Injuries of the midtarsal joint[J]. J Bone Joint Surg Br,1975,57:89-97.
[4] Sayyed Hosseinian SH,Hassankhani GG,Bagheri F,et al. Validation of the persian version of the American Orthopedic Foot and Ankle Society Score(AOFAS)Questionnaire[J]. Arch Bone Jt Surg,2018, 6(3):233-239.
[5] van Dorp KB,de Vries MR,der Elst MV,et al. Chopart joint injury:a study of outcome and morbidity[J]. J Foot Ankle Surg,2010,49(6):541-545.
[6]夏青,杨云峰,俞光荣. Chopart骨折脱位的基础和临床研究进展[J].中国矫形外科杂志,2012,20(2):137-140.XIA Q,YANG YF,YU GR. The basic and clinical research progress in Chopart fracture dislocation[J]. Zhongguo Jiao Xing Wai Ke Za Zhi,2012,20(2):137-140. Chinese.
[7]汤样华,曾林如,岳振双,等.开放性跖跗关节损伤的手术治疗[J].中国骨伤,2017,30(2):159-162.TANG YH,ZENG LR,YUE ZS,et al. Surgical treatment of open tarsal joint injury[J]. Zhongguo Gu Shang/China J Orthop Trmuma,2017,30(2):159-162. Chinese with abstract in English.
[8] Rammelt S,Schepers T. Chopart injuries:when to fix and when to fuse[J]. Foot Ankle Clin,2017,22(1):163-180.
[9] Faglia E,Clerici G,Frykberg R,et al.Outcomes of Chopart amputation in a tertiary referral diabetic foot clinic:data from a consecutive series of 83 hospitalized patients[J]. J Foot Ankle Surg,2016,55(2):230-234.
[10] Sancho González I,Menéndez García M. Missed Chopart dislocation. The importance of being aware of midtarsal injuries[J]. An Sist Sanit Navar,2016,39(1):153-158.
[11]鲁强,王平凡.多层螺旋CT后处理技术在足骨骨折诊断中的应用[J].山东医药,2009,49(3):43-44.LU Q,WANG PF. Application of post-processing technique of multi slice spiral CT in diagnosis of fracture of foot bone[J]. Shan Dong Yi Yao,2009,49(3):43-44. Chinese.
[12] Harrasser N,Gradl G. Mid foot fractures of the chopart and lisfranc joint line[J]. MMW Fortschr Med,2014,156(8):54-55.
[13] Walter WR,Hirschmann A,Alaia EF,et al. Journal club:MRI evaluation of midtarsal(Chopart)sprain in the setting of acute ankle injury[J]. AJR Am J Roentgenol,2018,210(2):386-395.
[14] Tafur M,Rosenberg ZS,Bencardino JT. MR imaging of the midfoot includingChopart and lisfranc joint complexes[J]. Magn Reson Imaging Clin N Am,2017,25(1):95-125.
[15]华强,赵慧毅,陈刚,等. Chopart关节损伤的手术治疗方法与疗效观察[J].中国骨与关节损伤杂志,2015,30(10):1114-1116.HUA Q,ZHAO HY,CHEN G,et al. Chopart surgical treatment of joint injury and curative effect observation[J]. Zhongguo Gu Yu Guan Jie Sun Shang Za Zhi,2015,30(10):1114-1116. Chinese.
[16]黄杰烽,郑杨,陈星,等.伴第2跖骨基底部粉碎的Lisfranc损伤的手术治疗[J].中国骨伤,2015,28(2):171-173.HUANG JF,ZHENG Y,CHEN X,et al. Surgical treatment for Lisfranc injuries accompanied by the base crashing of the second metatarsal bone[J]. Zhongguo Gu Shang/China J Orthop Trmuma,2015,28(2):171-173. Chinese with abtstract in English.
[17]俞光荣,洪浩.踝关节损伤的治疗进展与思考[J].中国骨伤,2016,29(12):1071-1073.YU GR,HONG H. Development and think about ankle joint injury[J]. Zhongguo Gu Shang/China J Orthop Trmuma,2016,29(12):1071-1073. Chinese.