空心加压螺钉联合克氏针治疗跖跗关节骨折脱位

目的探讨切开复位空心加压螺钉联合克氏针内固定治疗跖跗关节骨折脱位的疗效。方法 35例跖跗关节骨折脱位的患者采用切开复位空心加压螺钉联合克氏针内固定治疗,术后复查X线片评估复位情况,应用美国矫形足踝协会（AOFAS）中足评分标准对患足术后功能进行评定。结果骨折脱位均解剖复位。术后伤口感染3例。35例均获随访,时间6～34个月。功能评定：优14例,良15例,可4例,差2例。发生创伤性关节炎6例,3例药物治疗后症状缓解,3例行跖楔关节融合术。结论切开复位空心加压螺钉联合克氏针内固定治疗跖跗关节骨折脱位能够达到解剖复位及坚强固定,效果满意。

Treatment of fracture and dislocation of tarsometatarsal joint with cannulated screws and Kirschner wires

Objective To evaluate the therapeutic effect of treatment of tarsometatarsal joint injuries with cannulated screws and Kirschner wires.Methods 35 cases of tarsometatarsal joint injuries were treated with open reduction and cannulated screw united with Kirschner wire internal fixation.The reduction was evaluated by X-ray examination after operation.The patient′s function were scored by the American Orthopaedic Foot and Ankle Society（AOFAS） midfoot score.Results All fracture and dislocation of tarsometatarsal joint were anatomical reduced by operation.3 wounds got infection after operation.This group of patients were followed up for 6~34 months.The foot function was evaluated according to AOFAS：14 cases were excellent,15 good,4 fair,and 2 poor.6 cases had traumatic arthritis,3 cases were relived by pharmacotherapy,3 cases were give tarsometatarsal joint fusion.Conclusions The therapeutic effect of treatment of tarsometatarsal joint injuries with cannulated screws and Kirschner wires is excellent,and the fracture and dislocation of tarsometatarsal joint can be reduced anatomically and fixed stably.