Transverse Dorsal Approach to the Midfoot Joints in Acute Traumatic Injury

Kupcha, Paul; Gradisek, Brian

doi:10.1097/btf.0000000000000083

Cited by 2 publications

(5 citation statements)

References 8 publications

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“…These rates are comparable to those in the literature of 0% to 9% superficial infection and 0% to 13% delayed healing. 7,12,13,17,19,25,29,[31][32][33] The majority of patients underwent a subsequent removal of hardware procedure, and 13% of these patients experienced complications after this procedure. Our findings suggest that the use of a single incision with intervals to the TMTJ is a viable way of approaching and visualizing the medial Lisfranc injury, while minimizing soft tissue compromise.…”

Section: Discussionmentioning

confidence: 99%

“…33 Kupcha et al reported a series of 60 traumatic Lisfranc injuries with an 8% rate of impaired sensation and 8% rate of delayed wound healing postoperatively. 13 The authors attributed these complications in part to the high-impact mechanism of injury, with potential neurologic damage occurring at the time of injury.…”

Section: Discussionmentioning

confidence: 99%

“…Anatomic reduction can best be achieved via an open approach but may incur wound dehiscence, skin necrosis, soft tissue infection, neuroma formation, and development of complex regional pain syndrome (CRPS). 7,9,13,19,22,25,[31][32][33] Traditionally, the approach to the midfoot has involved multiple longitudinal incisions over the dorsum of the foot separated by skin bridges. 2,19 However, the risks of this approach include poor visualization of the transversely oriented TMTJ, as well as the potential for skin necrosis between the narrow skin bridges.…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…Wound complications have also been documented with this approach. 13,33 There is much literature comparing the outcomes of various fixation methods and arthrodesis; however, few describe approach-related complications, and choice of approach remains largely surgeon dependent. In this study, we describe a modified dorsal approach that utilizes a single longitudinal incision with multiple intervals or windows to the midfoot and quantify the incidence of complications when used in a large consecutive series at our center.…”

Section: Introductionmentioning

confidence: 99%

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Modified Dorsal Approach in the Management of Lisfranc Injuries

et al. 2018

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Modified Dorsal Approach in the Management of Lisfranc Injuries

et al. 2018

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Outcomes of a Nontraditional Dual Incision Approach for Lisfranc Trauma, Fractures, and Osteoarthritis

Blazek

Patel

Burns

2019

Techniques in Foot &Amp; Ankle Surgery

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Background: Numerous surgical approaches and treatments for Lisfranc pathology have been described and vary across physicians and surgical specialties. Many incisions to access the tarsometatarsal (TMT) joint complex have been described including single and dual longitudinal as well as transverse. The aim of this study was to retrospectively review and compare complication and fusion rates in patients with a Lisfranc open reduction and internal fixation or arthrodesis utilizing a nontraditional dual incision approach. Incisions were performed dorsal medial to the first TMT and dorsal along the second interspace just medial to the third TMT. Materials and Methods: The medical records of 1 foot and ankle surgeon were reviewed of patients who underwent Lisfranc surgery utilizing a dual incision approach for both elective and traumatic procedures. The study period encompassed January 2006 through December 2016. Statistical analysis was performed using information collected from chart-review as well as radiograph evaluation to examine predictors of complications and fusion rates. Results: Sixty-eight patients reviewed had the nontraditional dual dorsal incisions, 61 with TMT fusions for arthritis or injury, and 7 open reduction and internal fixation for TMT injuries. In total, 180 joint fusions were performed on the first, second, or third TMTs during arthrodesis. Four of 68 patients were revisions of previously failed fusions. All 68 patients (100%) healed soft tissue without complication. Of the 180 joints that underwent arthrodesis 170 (94.4%) fused successfully. Hardware removal occurred in 10 patients (14.7%) due to discomfort. Conclusions: This nontraditional dual incision dorsal approach for Lisfranc surgery has a low wound healing complication rate, in fact none were reported in this sample size of 68 patients. This approach is reproducible for either traumatic or elective procedures of the Lisfranc complex allowing excellent visualization of the medial and central tarsometatarsal joints while removing risk to the neurovascular structures inherent in the more traditional incisions. Level of Evidence: Diagnostic Level IV. See Instructions for Authors for a complete description of levels of evidence.

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Transverse Dorsal Approach to the Midfoot Joints in Acute Traumatic Injury

Cited by 2 publications

References 8 publications

Modified Dorsal Approach in the Management of Lisfranc Injuries

Modified Dorsal Approach in the Management of Lisfranc Injuries

Outcomes of a Nontraditional Dual Incision Approach for Lisfranc Trauma, Fractures, and Osteoarthritis

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