Pediatric Lisfranc fracture — a subdiagnosticated injury

Duarte, Márcio Luí­s; Campozana, Natalia Sacchi; Reis, Lara Marinho; Silva, André de Queiroz Pereira da; Prado, José Luiz Masson de Almeida; Scoppetta, Luiz Carlos Donoso

doi:10.5935/2238-3182.20190009

Cited by 2 publications

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“…Entretanto, pode surgir em outras localidades, como na cabeça medial desse mesmo músculo. É uma ossificação de caráter endocondral de modo total ou parcial e que, em condições não patológicas, pode chegar a medir 1,5 cm (1)(2)(3)(4) .…”

Section: Introductionunclassified

Fratura da fabela – avaliação pelos exames de imagem / Fracture of the fabella – evaluation by imaging exams

Segatt,

Pires,

Duarte

2023

Arq Med Hosp Fac Cienc Med Santa Casa São Paulo

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Introdução: A fabela é um osso do tipo sesamoide que se localiza classicamente no interior do tendão da cabeça lateral do gastrocnêmio. Esse tipo de ossificação não está presente em toda a população mundial. Assim, sua fratura é um caso raro e de difícil diagnóstico. Objetivo: Relatar um caso e revisar a literatura acerca desta fratura incomum. Relato do Caso: Paciente do sexo feminino, de 66 anos, apresenta dor no joelho há dois anos impedindo-a de deambular por grandes distâncias bem como subir e descer escadas. A ressonância magnética identificou edema importante da fabela com uma fratura horizontal. Conclusão: O tratamento da fratura da fabela pode ocorrer tanto de maneira conservadora quanto de modo cirúrgico. Entretanto, o processo cirúrgico apresenta alívio imediato da dor e é o tratamento definitivo dessa moléstia. Casos tratados de modo conservador, isto é, com fisioterapia, analgesia e imobilização, apresentam menores taxas de sucesso.Palavras-chave: Ossos sesamoides, Joelho, Músculo gastrocnêmio, Radiografia, Imageamento por ressonância magnética, Fraturas ósseas. ABSTRACT Introduction: The fabella is a sesamoid bone that is classically located inside the tendon of the lateral head of the gastrocnemius. This type of ossification is not present in the entire world population. Thus, such a fracture is a rare case and difficult to diagnose. Objective: To report a case and review the literature about this uncommon fracture. Case report: A 66-year-old female patient has had knee pain for two years, preventing her from walking long distances and going up and down stairs. Magnetic resonance imaging identified a significant edema of the fabella with a horizontal fracture. Conclusion: Fabella fractures can be treated both conservatively and surgically. However, the surgical process provides immediate pain relief and is the definitive treatment for this disease. Cases treated conservatively, that is, through physiotherapy, analgesia, and immobilization, have lower success rates.Keywords: Sesamoid bones, Knee, Fracture, Gastrocnemius muscle, Radiography, Magnetic resonance imaging, Bone fractures.

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Section: Introductionunclassified

Fratura da fabela – avaliação pelos exames de imagem / Fracture of the fabella – evaluation by imaging exams

Segatt,

Pires,

Duarte

2023

Arq Med Hosp Fac Cienc Med Santa Casa São Paulo

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“…In children, Lisfranc injuries are extremely rare and little evidence exists to guide the diagnosis and management in the pediatric population. A reduced number of case series exist in the pediatric orthopedic literature [2,[4][5][6][7][8][9][10][11][12], the largest article includes only 56 patients [2]. These injuries in the pediatric population are not only rare but also present similarities to adult Lisfranc injuries, they are frequently misdiagnosed or overlooked.…”

Section: Introductionmentioning

confidence: 99%

Pediatric Lisfranc Fracture-Dislocation: A Case Report

Ventura¹,

Ferreira²,

Rodrigues³

et al. 2022

Cureus

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Lisfranc injury is extremely rare in the pediatric population and little evidence exists to guide the treatment at this age.We present a clinical case of a rare Lisfranc fracture-dislocation at pediatric age. An 11-year-old male was admitted to the emergency department, in October 2020, after a motorcycle incident. He was diagnosed with a Lisfranc fracture-dislocation of the right foot: Myerson type B2. Fourteen days after the injury, he underwent surgical treatment with open reduction and internal fixation with 3.5 mm solid fully threaded screws.At 18 months postoperative, the patient was asymptomatic, didn't present any limitations, presented an American Orthopedic Foot and Ankle Score (AOFAS) midfoot score of 93%, and excellent results of the 12-Item Short Form Survey (SF-12) -PCS-12 (Physical Score): 52.52277 and MCS-12 (Mental Score): 62.12820. The foot maintained a good configuration without significant malalignment, however, a screw breakage occurred before the implant removal, and a premature physeal arrest developed on the base of the first metatarsal bone.Clinical and radiographic evaluation of Lisfranc injuries may be challenging in the pediatric population. Regarding the treatment, anatomical alignment is mandatory, and good or excellent outcomes have been achieved with anatomical reduction and internal fixation. We recommend early implant removal to avoid screw breakage and avoid the use of screws in the first metatarsal physis, due to the risk of premature physeal arrest.

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Pediatric Lisfranc fracture — a subdiagnosticated injury

Cited by 2 publications

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Fratura da fabela – avaliação pelos exames de imagem / Fracture of the fabella – evaluation by imaging exams

Fratura da fabela – avaliação pelos exames de imagem / Fracture of the fabella – evaluation by imaging exams

Pediatric Lisfranc Fracture-Dislocation: A Case Report

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