复杂中足损伤13例治疗分析

摘要

Objective:To investigate the operation treatment effect of complex midfoot injury.Method:Thirteen cases of complex midfoot injury were admitted to author’s hospital from June 2008 to March 2012.All cases were open fracture and dislocation,11 cases with soft tissue defect.7 cases were given emergency treatment for fracture dislocation fixation Ⅰflap to repair soft tissue,4 cases were given Ⅱstage soft tissue repair emergency debridement for fracture dislocation fixation after 1 week.Result:All cases were 4-46 months follow-up,an average of 11.6 months.All transplantation flaps were survived.The postoperative function of injured foot was evaluate according to the midfoot score standard of AOFAS,excellent in 3 cases,good in 5 cases,fair in 3 cases,poor in 2 cases.Conclusion:Complicated midfoot injury should be given early operation on the basis of fully understanding functional anatomy and trauma pathology, pay attention to fracture and dislocation at the same time,pursue the treatment of soft tissue,in order to achieve a good effect.%目的：探讨复杂中足损伤手术治疗效果。方法：2008年6月-2012年3月治疗复杂中足损伤患者13例，均为开放性骨折脱位，伴有软组织缺损者11例。急诊行骨折脱位复位内固定Ⅰ期皮瓣软组织修复7例；急诊清创行骨折脱位复位内固定术后1周，Ⅱ期软组织修复4例。结果：全部患者获得随访，时间4~46个月，平均11.6个月。移植皮瓣全部成活。根据(AOFAS)的中足评分标准对患足术后的功能进行评定，优3例，良5例，可3例，差2例。结论：复杂的中足损伤应在充分了解功能解剖、创伤病理的基础上早期手术，重视骨折脱位的同时，兼顾软组织的处理，才能取得较好的疗效。