Outcome After Open Reduction and Internal Fixation of Lisfranc Joint Injuries*

Kuo, Roderick S.; Tejwani, Nirmal C.; DiGiovanni, Christopher W.; Holt, Sarah K.; Benirschke, Stephen K.; Hansen, Sigvard T.; Sangeorzan, Bruce J.

doi:10.2106/00004623-200011000-00015

Cited by 385 publications

(415 citation statements)

References 21 publications

Supporting

Mentioning

380

Contrasting

Unclassified

Order By: Relevance

“…A total of 11 papers satisfied the inclusion criteria and received critical analysis [2,11,17,21,23,30,31,33,34,38,39]. There were seven case series retrospective studies [2,17,30,31,33,38,39], two comparative cohort studies [23,34], and two prospective randomised control trials-comparative studies [11,21].…”

Section: Resultsmentioning

confidence: 99%

The role of reduction and internal fixation of Lisfranc fracture–dislocations: a systematic review of the literature

Stavlas

Roberts

Xypnitos

et al. 2010

International Orthopaedics (SICOT)

141

127

View full text Add to dashboard Cite

A systematic review of the literature was performed in order to evaluate the role of reduction and internal fixation in the management of Lisfranc joint fracturedislocations. Articles were extracted from the Pubmed database and the retrieved reports were included in the study only if pre-specified eligibility criteria were fulfilled. Eleven articles were eligible for the final analysis, reporting data for the management of 257 patients. Injuries of the first three metatarsal rays were treated by closed reduction and internal fixation with screws in 16.3% of the patients, open reduction and internal fixation with screws in 66.5% and open reduction and internal fixation with Kirschner wires (K-wires) in 17.1% of the patients. The preferred method for the stabilisation of the fourth and fifth metatarsal rays was K-wires. Screw-related complications were common and were reported in 16.1% of the cases. The mean American Orthopaedic Foot and Ankle Society midfoot score was 78.1 points. Post-traumatic radiographic arthritis was reported in 49.6% of the patients, but only in 7.8% of them it was severe enough to warrant an arthrodesis. We conclude that open reduction and internal fixation of the first three metatarsal rays with screws is a reliable method for the management of Lisfranc injuries. This can be complemented by K-wires application in the fourth and fifth metatarsal rays if needed.

show abstract

Section: Resultsmentioning

confidence: 99%

The role of reduction and internal fixation of Lisfranc fracture–dislocations: a systematic review of the literature

Stavlas

Roberts

Xypnitos

et al. 2010

International Orthopaedics (SICOT)

141

127

View full text Add to dashboard Cite

show abstract

“…The most common long-term complication of a Lisfranc joint injury is chronic pain secondary to posttraumatic osteoarthritis, particularly if the congruency and stability of the Lisfranc articulation are not reestablished. 2,3,5,[7][8][9] Lisfranc joint injuries can be difficult to recognize and are commonly misdiagnosed during the initial examination by a health care provider. 3,10,11 Midfoot swelling and the inability of the patient to bear weight on the affected foot, either immediately after the injury or when examined in the office, might be the only clues that this injury has occurred.…”

Section: Discussionmentioning

confidence: 99%

“…2,4,12 Most investigators have concluded that there is little place for the nonoperative management of Lisfranc fracture-dislocations when a 2-mm or greater diastasis is found between the bases of the first and second metatarsals and medial and middle cuneiforms, because it is difficult to maintain anatomic reduction by closed reduction and immobilization alone. 1,2,4,5,7,9,14,15 Curtis et al 16 recommend surgical reduction for all athletes and active persons. Surgical reduction as soon as possible after the injury is recommended by most orthopaedic surgeons.…”

Section: Dotted Lines) a 2-mm Diastasis Is Noted Between The Medial mentioning

confidence: 99%

A Lisfranc Fracture-Dislocation in a Football Player

Harwood¹,

Raikin²

2003

The Journal of the American Board of Family Medicine

View full text Add to dashboard Cite

Injuries to the tarsometatarsal joint, also known as Lisfranc injuries, are uncommon and can be difficult to diagnose. These injuries have a high potential for causing substantial disability related to posttraumatic osteoarthritis. As a result, it is important to be alert for these injuries when evaluating patients after acute foot trauma. This case report describes a collegiate athlete with a Lisfranc fracture-dislocation. Relevant aspects of the physical examination, diagnostic imaging, and treatment considerations are discussed. Case ReportThe patient, a 22 year-old male collegiate football player, was examined on the field after sustaining an injury to his right foot. After falling on a plantarflexed, fixed foot, an axial load was applied to the posterior aspect of the patient's right heel. He developed immediate pain and swelling over the dorsum of the foot, and he was unable to bear weight on his foot. His medical and surgical history were unremarkable.When the patient was examined, he was in extreme discomfort. He had considerable swelling over the dorsum of the midfoot. His foot was diffusely tender with areas of maximal tenderness over the first and second tarsometatarsal joints, the medial cuneiform, and between the first and second metatarsal heads. The foot was otherwise neurologically intact.The patient was sent to the local emergency department for radiographs immediately after the injury. Non-weight-bearing anteroposterior, lateral, and oblique radiographs were obtained. The physicians caring for the patient in the emergency department, including the on-call radiologist, did not observe any abnormalities on the initial films. The patient was released from the emergency department with crutches and a postoperative shoe. He was told that he had a severe sprain of his foot. When the patient brought the radiographs to the training room the next day, a fracture of the medial cuneiform was seen in addition to 2 mm of widening between the medial and middle cuneiform articulation, findings consistent with a Lisfranc fracture-dislocation (Figure 1). The patient's foot was placed in a fracture boot, and he was assigned to strict non-weight-bearing status. He was then referred to a foot and ankle surgeon, who took him to the operating room 4 days after the injury for open reduction and internal fixation of both the medial cuneiform fracture and the Lisfranc dislocation. A cannulated screw was placed from the medial aspect of the medial cuneiform across the Lisfranc articulation into the base of the second metatarsal. A second screw was placed across the medial cuneiform into the middle cuneiform (Figure 2). The patient was instructed to remain non-weight bearing, and his foot was put in a cast to immobilize it. He was then given a fracture boot to wear for 6 weeks. He was gradually weaned from his fracture boot without difficulty. The hardware was removed 19 weeks after surgery. At 42 weeks after surgery and 22 weeks after removal of the screws, the patient was asymptomatic and was given permission to partic...

show abstract

“…As with midfoot injuries, those managed nonoperatively had poorer outcomes than those treated surgically ( Figure 7). 84,85 Fractures of the metatarsals are common injuries, which rarely require surgical intervention. However, certain injury patterns require a surgical intervention to obtain a satisfactory outcome.…”

Section: Foot Fracturesmentioning

confidence: 99%

Management of High-Energy Foot and Ankle Injuries in the Geriatric Population

Herscovici

Scaduto

2012

Geriatr Orthop Surg Rehabil

View full text Add to dashboard Cite

By the year 2035 almost 20% of the US population of 389 million people will be 65 years and older. What this group has, compared with aged populations in the past, is better health, more mobility, and more active lifestyles. From January 1989 through December 2010, a total of 494 elderly patients with 536 foot and ankle injuries were identified. Within this group, 237 (48%) patients with 294 injuries were sustained as a result of a high-energy mechanism. These mechanisms consisted of 170 motor vehicle accidents, 30 as a result of high (not ground level) energy falls, 2 from industrial accidents, and 35 classified as other, which included sports, blunt trauma, bicycle, airplane or boating accidents, crush injuries, and injuries resulting from a lawn mower. The injuries produced were 17 metatarsal fractures, 9 Lisfranc injuries, 10 midfoot (navicular, cuneiform, or cuboid) fractures, 23 talus fractures, 63 calcaneal fractures, 73 unimalleolar, bimalleolar, or trimalleolar ankle fractures, 45 pilon fractures, and 3 pure dislocations of the foot or ankle. Overall, 243 (83%) of these injuries underwent surgical fixation and data have shown that when surgery is used to manage high-energy injuries of the foot and ankle in the elderly individuals, the complications and outcomes are similar to those seen in younger patients. Therefore, the decision for surgical intervention for high-energy injuries of the foot and ankle should be based primarily on the injury pattern and not solely on the age of the patient. Keywords elderly, geriatric, high-energy injuries, foot and ankleThe 2010 census demonstrated that of the 308 million people living in the United States, 13% were aged 65 and older 1 and that, except for those in the 45 to 65 years bracket, this group grew at a faster rate than any other segment of the population. 2 Extrapolation data have estimated that by the year 2035, almost 20% of the US population of 389 million people will be 65 years and older. 3

show abstract

Outcome After Open Reduction and Internal Fixation of Lisfranc Joint Injuries*

Cited by 385 publications

References 21 publications

The role of reduction and internal fixation of Lisfranc fracture–dislocations: a systematic review of the literature

The role of reduction and internal fixation of Lisfranc fracture–dislocations: a systematic review of the literature

A Lisfranc Fracture-Dislocation in a Football Player

Management of High-Energy Foot and Ankle Injuries in the Geriatric Population

Contact Info

Product

Resources

About