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Chấn thương mô mềm

Tarsometatarsal doanh phức tạp, gãy xương lệch kết quả từ tháng chấn thương trực tiếp hoặc gián tiếp. Thương tích là kết quả trực tiếp của lòng thường có liên quan và hội chứng ngăn GỒM tháng, đáng kể chấn thương mô mềm, và fracturedislocation mở. Thương tích là thường là kết quả gián tiếp của năm trục tải đến chân plantarflexed. | Injury to the Tarsometatarsal Joint Complex Michael C. Thompson MD and Matthew A. Mormino MD Abstract Tarsometatarsal joint complex fracture-dislocations may result from direct or indirect trauma. Direct injuries are usually the result of a crush and may involve associated compartment syndrome signi cant soft-tissue injury and open fracturedislocation. Indirect injuries are often the result of an axial load to the plantarflexed foot. Midfoot pain after even a minor forefoot injury should raise suspicion up to 20 of tarsometatarsal joint complex injuries are missed on initial examination. An anteroposterior radiograph with abduction stress may reveal subtle injury but computed tomography is the preferred imaging modality. The goal of treatment is the restoration of a pain-free functional foot. The preferred treatment is open reduction and internal xation using screw xation for the medial three rays and Kirschner wires for the fourth and fth tarsometatarsal joints. Satisfactory outcome can be expected in approximately 90 of patients. J Am Acad Orthop Surg 2003 11 260-267 Lisfranc described amputations through the tarsometatarsal TMT joint for the treatment of severe gangrenous midfoot injuries and his name has been associated with many different injuries to this region.1 Myerson2 described such injuries as involving the tarsometatarsal complex TMC which includes the metatarsals and TMT joints the cuneiforms the cuboid and the navicular.2 The spectrum of TMC injury ranges from low-energy trauma such as a misstep to high-energy crush injuries characterized by extensive osseous comminution and soft-tissue compromise. Accordingly the pattern of TMC injury is highly variable and may involve purely ligamentous disruptions without fracture associated metatarsal fractures or fractures of the cuneiforms cuboid or navicular. Accurate diagnosis of these injuries is paramount. Although only minimal displacement may be present on initial radiographs severe ligamentous disruption