Objective: To discuss the methods and clinical outcomes of selective tarsometatarsal (TMT) arthrodesis for old Lisfranc injury. Methods: The clinical data of 36 cases with old Lisfranc injury treated by selective arthrodesis from January 2010 to October 2016 in the Department of Orthopedics in Shanghai Sixth People's Hospital were analyzed retrospectively. There were 16 males and 20 females in this group with a mean age of (40±6) years. The information of pre-operative and post-operative X-ray, American Orthopaedics Foot and Ankle Society (AOFAS) midfoot score and pain Visual Analogue Scale (VAS) score was collected. The complications were also recorded. The pre- and post-operative data were compared with t test. Results: The 36 patients got a follow-up for at-least 2 years (averaged (4.3±1.6) years, ranged from 2 to 8 years). The post-operative AOFAS midfoot score was improved from (44±7)(28-60) to (83±7)(76-97)(t=-37.1, P<0.05), and the VAS score decreased from (6.3±2.5)(5-9) to (1.6±1.3)(0-3)(t=23.7, P<0.05). Implant breakage occurred in two patients and the symptom was relieved after the removal of implants. Conclusion: The selective TMT arthrodesis for old Lisfranc injury may relieve the symptoms, improve the function and life quality of patients by restoring the medial arch and midfoot and forefoot alignment.
目的： 探讨采用选择性跖跗关节融合术治疗陈旧性Lisfranc损伤的方法与疗效。 方法： 分析2010年1月至2016年10月于上海市第六人民医院骨科行选择性跖跗关节融合术治疗的36例陈旧性Lisfranc损伤患者的临床资料。其中男16例，女20例，平均年龄（40±6）岁。整理患者术前及末次随访时的足正斜及侧位片、美国骨科足踝外科协会（AOFAS）中足评分、疼痛视觉模拟评分（VAS），并记录相关并发症。术前及术后末次随访AOFAS中足评分及VAS评分比较采用配对t检验。 结果： 36例患者获得随访，平均随访（4.3±1.6）年。AOFAS评分由术前平均（44±7）分（28~60分）升至末次随访时的（83±7）分（76~97分），差异有统计学意义（t=-37.1，P<0.05）；VAS评分由术前平均（6.3±2.5）分（5~9分）降至末次随访时的（1.6±1.3）分（0~3分），差异具有统计学意义（t=23.7，P<0.05）。随访期间2例发生内固定断裂，后予以取出内固定，相应症状得到缓解。 结论： 选择性跖跗关节融合可有效重建足弓、恢复中前足力线，从而缓解症状，改善功能，提高患者生活质量。.
Keywords: Arthrodesis; Internal fixation; Lisfranc joint; Old injury.