跖跗关节损伤的手术治疗

目的：总结跖跗关节损伤切开复位内固定的临床经验，评价手术治疗效果。方法：自2009年3月至7月，9例跖跗关节损伤的患者接受切开复位内固定术，其中男7例，女2例；年龄20～47岁，平均33.5 岁。损伤按Quenu-Kuss分型：A型5例，B型3例，C型1例。采用1～2个足背纵行直切口，克氏针和空心螺钉内固定。依据美国矫形足踝协会(AOFAS)足评分标准对患足的功能进行评定。结果：9例患者均获得随访，时间5～12个月，平均8个月。术后感染1例，1例发生创伤后关节炎，无克氏针松动。AOFAS总评分由术前的(15.5±4.2)分提高到术后的(92.0±5.2)分(t=-45.95,P<0.01);9例患者中，好7例，较好1例，差1例。结论：切开复位治疗跖跗关节损伤可取得满意效果。

Surgical treatment of tarsometatarsal joints injury

Objective: To summmarize the clincal experience of open reduction and internal fixation for the treatment of tarsometatarsal joint injury ane evaluate the effects of operative treatment to tarsometatarsal joint injury. Methods: From March to July in 2009,9 patients with tarsometatarsal joint injury were treated by open reduction and internal fixation included 7 males and 2 females with an average age of 33.5 years old ranging from 20 to 47 years. According to Quenu-Kuss classification,there were 5 cases of type A,3 of type B,1 of type C. All patients were treated by cannulated screws and Kirschner wires through 1 to 2 microtubule straight incision on dorsum of foot. The foot function were assessed by American Orthopaedic Foot and Ankle Society (AOFAS) midfoot score. Results: All patients were followed up for 5 to 12 months with an average of 8 months. Complications concluded 1 case with infection,1 case with post-traumatic arthritis. The failure of Kirschner wires was not discovered in 9 cases. According to AOFAS system,the total scores increased from preoperative (15.5±4.2) to postoperative (92.0±5.2) (t=-45.95,P<0.01). The results were excellent in 7 cases,good in 1,and poor in 1. Conclusion: Open reduction and internal fixation for the reatment of tarsometatarsal joint injury should have satisfying results.