严重跖跗关节骨折脱位的治疗

目的探讨严重跖跗关节脱位及骨折脱位的治疗方法及临床疗效。方法对2003年1月至2007年12月收治的29例严重跖跗关节损伤患者进行回顾性研究，均采用内固定和外固定相结合的方法。应用美国骨科矫形足踝协会足评分标准和目测类比疼痛评分法，分别评价足术后功能状况及手术前后疼痛情况。结果29例随访1～5年（平均2年），感染1例，足骨筋膜室综合征2例，创伤性关节炎5例。依据美国矫形足踝协会足评分标准对患足术后的功能进行评定，优8例，良13例，可6例，差2例。结论通过解剖及功能复位，给予内或外固定相结合的治疗方法，可使严重跖跗关节损伤得到有效的治疗，减少了病残率。

Treatment of Severe Tarsometatarsal Joint Injury

Objective To evaluate the therapeutic effect of fracture-dislocation of the tarsometatarsal joint.Methods From Jan 2003 to Dec 2007,a retrospective study of patients with tarsometatarsal joint injury.Among twenty-nine patients,those cases were treated with intro or/and extro fixation.After the operation,the outcome was evaluated by visual analogy scale(VAS)and the American Orthopaedic Foot and Ankle Society(AOFAS)midfoot score.Results 29 patients were followed for an average of fourteen months.Complications were infections with 1 cases,2 of pre-operation fore-foot compartment syndromes took place,post-traumatic arthritis in 6.The outcomes were assessed by AOFAS mid-foot score,the results were excellent in 8 cases,good in 13,mild 6,and poor in 2.Conclusion Throug Anatomical and functional reduction,intro or/and extro fixation methods of tarsometatarsal join injury results to the well long-term outcomes,diminishing the rate of disease deficient.