Temporary Bridging of Severe Medial Column Injury of the Foot using Internal Fixation: 使用內固定支架原理來為嚴重足部內側柱損傷作臨時橋接：病例報告

Inadequate treatment of midfoot crush injury often leads to permanent disability. The principle of treatment is to restore foot column length and joint congruity while it is stable enough to allow an early rehabilitation. Choices of treatment include external fixation plus pinning, circular frame fixation, and open reduction plus internal fixation. External fixation is minimally invasive but it poses the threat of inaccurate reduction, loss of reduction secondary to pin loosening, and pin tract infections. Open reduction and internal fixation per se allows good reduction of fragments and restoration of joint congruities but it lacks the protection of the whole construct. We report a case of severe midfoot crush injury that was treated with temporary bridging fixation using a low-profile locking plate. It is an evolving technique that solves the problems of external fixation, and a stable construct can be achieved for early weight bearing.

中 文 摘 要足部內側柱損傷如果治療不徹底，往往導致終身殘疾。治療的原則是恢復腳柱的長度和關節一致性，並且有足夠的穩定性讓病人早日進行康復治療。治療的選擇包括外固定支架和鋼針，圓框形支架固定，以及開放性復位和內固定。外固定支架雖然是微創，但它有復位不準確，因鋼針鬆動和感染造成的復位喪失等問題。開放性復位和內固定容許准確的復位和恢復關節一致性，但它缺少整個構建體的保護。我們報導一個嚴重足部內側柱損傷的病例，使用了低厚度的鎖定鋼板，作為臨時橋接固定。它是一個新發展的技術，解決了外固定支架的問題，同時提供穩定的結構讓讓病人可以提早作負重步行。