| 引用本文： |
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任昊旸,周海超,李兵,等.跖跗关节损伤内侧柱不同固定方式的临床分析[J].同济大学学报（医学版）,2016,37(5):71-76. [点击复制]
- REN Hao-yang,ZHOU Hai-chao,LI Bing,et al.Different fixation methods of medial column in treatment of tarsometatarsal joint injury[J].同济大学学报（医学版）,2016,37(5):71-76. [点击复制]
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| 摘要: |
| 目的 比较分析跖跗关节损伤内侧柱坚强固定与弹性固定的临床疗效。方法 回顾性分析2008年1月至2015年1月42例闭合性跖跗关节损伤患者资料,根据Chiodo和Myerson提出的三柱理论分类: 内侧柱、中间柱合并损伤26例,三柱合并损伤16例,所有病例均无明显的内侧柱脱位和不稳定。根据内侧柱固定方式分为内侧柱坚强固定组(22例)和弹性固定组(20例),两组一般资料比较差异均无统计学意义(P＞0.05)。对两组患者围手术期和术后随访的相关指标,包括临床查体和影像学资料、手术时间、住院时间、美国足踝外科协会(AOFAS)中足评分、疼痛视觉模拟评分(visual analogue scale, VAS),进行临床分析和统计学对比。结果 坚强固定组手术时间[(100.5±11.0)min]长于弹性固定组的[(92.8±10.3)min],术后外形情况坚强固定组优于弹性固定组,差异均具有统计学意义(P＜0.05),但两组住院时间、随访时间、术后一年的AOFAS中足评分、VAS评分的差异无统计学意义(P＞0.05)。结论 内侧柱坚强固定和弹性固定术后早期功能无显著差异。内侧柱坚强固定可有效维持复位,具有优势。 |
| 关键词: 跖跗关节 骨折固定术,内 分析 |
| DOI：10.16118/j.1008-0392.2016.05.015 |
| 投稿时间：2015-12-31 |
| 基金项目:国家自然科学基金(81472144) |
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| Different fixation methods of medial column in treatment of tarsometatarsal joint injury |
| REN Hao-yang,ZHOU Hai-chao,LI Bing,YANG Yun-feng |
| (Dept. of Orthopedics, Tongji Hospital, Tongji University, Shanghai 200065, China) |
| Abstract: |
| ObjectiveTo compare different fixation methods of medial column in treatment of tarsometatarsal joint injury. Methods Forty two patients with tarsometatarsal joint injury admitted between January 2008 and January 2015 were included in this retrospective study. According to Chiodo and Myerson's classification, there were 26 cases of both medial and middle columns injuries, 16 cases of three-column injuries. There were no significant signs of instability of the medial column in all the patients preoperatively. The patients were divided into rigid fixation group (n=22) and flexible fixation group (n=20), according to the fixation pattern of the medial column. There were no statistical significance of difference between the two groups in terms of general data (P＞0.05). Clinical evaluation, radiographic data, duration of operation, hospitalization time, American Orthopedic Foot Ankle Society (AOFAS) midfoot score and visual analogue scale (VAS) were recorded and compared in two groups. Results The mean duration of operation in rigid fixation group (100.5±11.0minutes) was significantly longer than that of flexible group (92.8±10.3minutes)(P＜0.05). Patients in rigid fixation group achieved significantly better outcomes in evaluation of foot alignment, compared with flexible fixation group(P＜0.05). There were no significant differences in hospitalization time, follow-up duration, AOFAS midfoot score and VAS score between two groups(P＞0.05). Conclusion There is no significant difference in short-term outcomes whether the medial column is treated by rigid or flexible fixation. Rigid fixation of the medial column is beneficial in maintaining the reduction with satisfactory results. |
| Key words: tarsometatarsal joint fracture fixation, internal analysis |
