The Clinical Analysis Of Lisfranc Injury

Objectives To compare the therapeutic effect of primary arthrodesis and open reduction and internal fixation(ORIF)in the treatment of Lisfranc joint injuries?Methods By computer retrieval Pub Med( January, 1980 to May, 2015) and Embas(January,1989 to May,2015), Medline(January,1966 to May,2015)?Science(January,1990 to May,2015),CNKI(January,1995 to December,2014),through manual retrieval the Chinese journal of orthopedic, the Chinese journal of surgical,Chinese Journal of Trauma during January,2000 to December,2014 about open reduction and internal fixation versus arthrodesis in the treatment of Lisfranc joint injuries(include randomized controlled trials and controlled clinical trials), First, to make strict inclusion and exclusion criteria,Then the NRCT according to MINORS rating scale score, Included RCT according to the Jadad scale score, using the Cochrane collaboration of Revman5.0 software for statistical analysis, the expression of continuous variables using the weighted mean difference(WMD) or standard mean difference(SMD) and 95% confidence intervals(95%CI), two categorical data using RR(relative risk) or OR(odds ratio) and 95% confidence interval(95%CI) as the evaluation indicator,According to the size of the heterogeneity choose a random effect model or fixed effect model,According to funnel figure judge literature bias.Results A total of 11 studies,including 4 randomized controlled trials and 7 clinical controlled trials,were qualified for meta analysis.There is no significant differences in second surgery and the incidence of the wound infection and paining. Compared with ORIF, primary arthrodesis was better in removing the internal fixation. In the comparison of the excellent rate,non-union and the incidence of complication, ORIF was better than arthrodesis.Conclusions Open reduction and internal fixation is better in the incidence of postoperative complications, postoperative good rate, Maryland score, postoperative nonunion than arthrodesis, arthrodesis is better in removing internal fixation. Two surgical approach was no significant difference in the incidence of reoperation comparisons, the rate of postoperative pain, postoperative wound infection rate. For mild Lisfranc injury, because fewer surgical complications, postoperative excellent rate, should be preferred open reduction and internal fixation for patients with severe Lisfranc injury,the reoperation rate was no significant difference due to joint fusion internal fixation surgery may not be removed, so the preferred arthrodesis.