摘要目的 评价Lisfranc关节损伤后局部软组织损伤程度与足部功能恢复程度之间的关系.方法 自2000年11月至2006年4月,共收治新鲜Lisfranc关节损伤患者43例(45足),平均年龄32岁.所有患者关节面均无毁损,未行融合手术,均行切开复位内固定,故可排除骨性因素影响.按跖跗关节损伤Quenu-Kuss分型:A型14足,B型21足,C型10足;按AO分类局部软组织损伤程度分为:不伴严重软组织损伤组29足和伴严重软组织损伤组16足,其中10例伴局部严重软组织损伤(1例伴足筋膜间隔综合征).术前时间平均7 d,所有患者均行切开复位内固定手术,术后石膏固定8～12周,均进行足负重正侧位X线检查和美国骨科足踝外科医师协会(AOFAS)功能评定.结果 随访时间12～69个月,平均37个月.所有患者均达到解剖复位,32例患者对手术疗效感到满意.术后AOFAS功能评定,关节损伤不伴严重软组织损伤组97分,伴严重软组织损伤组82分(P<0.05).结论 Lisfranc关节损伤后,足部功能恢复的程度不仅与关节损伤的程度相关,还与局部软组织损伤的程度相关.

abstractsObjective To evaluate the foot function after Lisfranc injury with local soft tissue in-jury. Methods From November 2000 to April 2006, 43 patients (at mean age of 32 years) with fresh Lisfranc injuries (45 sides) were managed with open reduction and internal fixation with screws, Kir-schner wires and AO plates. All patients had no joint surface damage and received no fusion surgery. Ac-cording to the Quenu-Kuss classification of Lisfranc injury, there were 14 patients with type-A injury, 21 with type-B and 10 with type-C. According to AO classification, there were 29 feet without severe soft tis-sue injury and 16 feet with severe soft tissue injury, of which 10 patients were combined with severe local soft tissue injury (one patient with Foot compartment syndrome). The period from injury to surgery was seven days. All patients received cast immobilization for 8-12 weeks and the foot function was evaluated by anteroposterior and lateral X-rays and American Orthopedic Foot and Ankle Society (AOFAS) score. Results All patients were followed up for 12-69 months (average 37 months), which showed that all pa-tients obtained anatomic reduction and 32 patients were satisfied with operative outcome. The average postoperative AOFAS score was 97 points for patients without severe soft tissue injury and 82 points for pa-tients with severe soft tissue injury (P<0.05). Conclusion After Lisfranc injury, the foot function is related to severity of both joint injury and local soft tissue injury.