背景:肖帕特受伤可以分为4大类,有或没有脱位的韧带损伤和有或没有脱位的骨折,必须发生在距骨关节(TNJ)和/或跟骨眼关节(CCJ)。肖帕特位错由纯位错和骨折位错组成。我们的目标是回顾文献,以支持基于证据的建议。
方法:进行文献检索,从电子数据库中找出相关文章,PubMed,Medline和Scopus.PRISMA流程图用于仔细检查搜索结果。文章按标题筛选,摘要和全文来确认相关性。
结果:我们确定了58篇论文进行分析,36例病例报告,4项队列研究,4例病例系列和14篇其他与流行病学有关的文章,诊断,Chopart脱位的治疗和结果。诊断建议包括包含计算机断层扫描(CT)的常规成像和室综合征的常规检查。治疗建议包括早期解剖复位,与柱长度和关节一致性的恢复和维护。对于纯脱位和骨折脱位,紧急切开复位内固定(ORIF)提供了最有利的长期结果。
结论:肖帕特脱位是一种复杂的异质性中足损伤,具有历史上较差的预后。关于这些伤害的研究相对较少。我们提供了与这些罕见病理的临床和外科治疗有关的循证建议。
BACKGROUND: Chopart injuries can be allocated into 4 broad groups, ligamentous injury with or without dislocation and fracture with or without dislocation, which must occur at the talonavicular joint (TNJ) and/or calcaneocuboid joint (CCJ). Chopart dislocations are comprised of pure-dislocations and fracture-dislocations. We aim to review the literature, to enable evidence-based recommendations.
METHODS: A literature search was conducted to identify relevant articles from the electronic databases, PubMed, Medline and Scopus. The PRISMA flow chart was used to scrutinise the search results. Articles were screened by title, abstract and full text to confirm relevance.
RESULTS: We identified 58 papers for analysis, 36 case reports, 4 cohort studies, 4 case series and 14 other articles related to the epidemiology, diagnosis, treatment and outcomes of Chopart dislocations. Diagnostic recommendations included routine imaging to contain computed tomography (CT) and routine examination for compartment syndrome. Treatment recommendations included early anatomical reduction, with restoration and maintenance of column length and joint congruency. For both pure-dislocations and fracture-dislocations urgent open reduction and internal fixation (ORIF) provided the most favourable long-term outcomes.
CONCLUSIONS: Chopart dislocations are a complex heterogenous midfoot injury with historically poor outcomes. There is a relative paucity of research discussing these injuries. We have offered evidence-based recommendations related to the clinical and surgical management of these rare pathologies.