Characteristics and treatment strategy of fresh high-energy fracture dislocation of tarsometatarsal joints
- VernacularTitle:新鲜高能量跖跗关节骨折脱位的临床特点及治疗策略
- Author:
Haibo ZHANG
;
Huaqiang LI
;
Xiao WANG
- Publication Type:Journal Article
- Keywords:
high-enerygy injury;
taraometatarsal joints;
fracture dislocation;
surgical treatment
- From:
Orthopedic Journal of China
2009;17(24):1841-1843
- CountryChina
- Language:Chinese
-
Abstract:
[Objective]To investigate the characteristics and treatment strategy for fresh high energy fracture dislocation of tarsometatarsal joints in a retrospective study.[Method]From September 2002 to April 2008,43 patients with fresh high energy fracture dislocation of tarsometatarsal joints were treated with cannulated screw combined with Kirschner wire fixation or Kirschner wire fixation alone.There were 35 males and 8 females,with a mean age of 37.5 years(range,18 to 55 years).The injury was caused by a road accident in 15 patients,by a heavy crash in 21 patients,and by a fall from a height in 7 patients.According to the Myerson damage typing,there were 9 cases of type A,2 cases of type of B1,25 cases of type B2,4 cases of type CI and 3 cases of type C2.Eight were open injuries(6 of Gustilo-Anderson type I and 2 of type Ⅱ)and 35 closed injuries.Internal fixation were undertaken at an average of 4.6 days after injury(range,2.5 hours to 21 days).At 4-6 weeks all the patients began functional exercises after removal of the plaster casts.At 16-18 weeks all the patients began to walk with partial weigh loading after removal of the internal fixators.[Result]All the 43 patients were followed up for 26 months on average(range,13 to 38 months).No infection,breakage,loosening of internal fixator,nonunion or longitudinal arch collapse was found.According to ZHOU'S assay standard.excellent result was achieved in 26 cases,good in 14 cases,and fair in 3 cases,with excellent to good results of 95.3%.Six patients had post-traumatic arthritis,which was complicated with injured articular surface.[Conclusion]Fresh high-energy fracture dislocation of tarsometatarsal joints can be diagnozed correctly.Early diagnosis and correct classification,proper operation timing,anatomical reduction,rational internal and external fixation and timely functional training are essential for patients to achieve good clinical result.
