摘要
目的分析Lisfranc中柱损伤的解剖学特征及对术后创伤性关节炎的影响。方法选取本院2015年1月~2016年1月间跖跗关节骨折患者90例作为研究对象,按照随机数表法,将其分为三组,分别采取背侧钢板内固定、空心螺钉单次贯穿及空心钉2次贯穿关节面内固定治疗,采用影像学检查中Lisfranc中柱损伤的解剖学特征,对术后出现创伤性关节炎的发生率等进行分析。结果研究中患者α角度较高患者包含56例,较低组包含患者34例;β角度较高患者包含53例,较低组包含患者37例。术后创伤性关节炎患者9例(10.00%)。α角度较低患者发生创伤性关节炎的发生率低于角度较高患者(P<0.05);年龄≤35岁的患者创伤性关节炎发生率低于年龄>35岁的患者(P<0.05);此外BMI水平正常患者以及使用空心螺钉单次贯穿治疗的患者在不同BMI水平以及不同手术方案的患者中均可见创伤性关节炎发生率最低(P<0.05)。Logistic回归分析表明α角度较高、年龄>35岁、超重或肥胖以及使用空心螺钉2次贯穿完成手术固定会增加术后创伤性关节炎的发生风险。结论临床α角度较高、年龄较大、超重或肥胖以及使用空心螺钉2次贯穿完成手术固定等可增加Lisfranc中柱损伤患者术后创伤性关节炎的发生风险。
Objective To analyze the anatomical characteristics of Lisfranc middle column injury and its effect on post- operative traumatic arthritis. Methods A total of 90 patients with tarsometatarsal joint fractures from January 2015 to January 2016 were selected as the study subjects. According to the random number table method, they were divided into three groups, who were given the dorsal plate internal fixation, hollow screw single penetration and penetration of articular surface fixation by hollow screw twice. The anatomical characteristics of the Lisfranc middle column injury in imaging studies were applied, and the incidence rate of postoperative traumatic arthritis was analyzed. Results In the study, the patients with a higher α angle included 56 patients, and the patients with a lower α angle included 34 patients; patients with a higher β angle included 53 patients, and those with a lower βangle included 37 patients. There were 9 patients with postoperative traumatic arthritis （10.00%）. The incidence rate of traumatic arthritis in the patients with a lower α angle was lower than that in the patients with higher angles（P〈0.05）; the incidence rate of traumatic arthritis in the patients with the age of≤35 years old was lower than those〉35 years old （P〈0.05）; in addition, the incidence rate of traumatic arthritis was the lowest in the patients with normal BMI and the patients undergoing hollow screw single penetration at different BMI levels and in different surgical protocols（P〈0.05）. Logistic regression analysis showed that higher ot angles, age 〉35 years, overweight or obesity, and undergoing the penetration of articular surface fixation by hollow screw twice increased the risk of postoperative traumatic arthritis. Conclusion Higher clinical α angle, elder age, overweight or obesity, and undergoing the penetration of articular surface fixation by hollow screw twice may increase the risk of postoperative traumatic arthritis in the patients with Lisfranc middle column injury.
作者
戴季林
夏增兵
胡文林
朱建祥
DAI Jilin;XIA Zengbing;HU Wenlin;ZHU Jianxiang(Department of Orthopedics,Huzhou First People＇s Hospital in Zhejiang Province,Huzhou 313000,China)
出处
《中国现代医生》
2018年第18期16-19,共4页
China Modern Doctor
基金
浙江省医药卫生科技计划项目(2017KY644)
