Treatment of Lisfranc Injuries Using Interosseous Suture Button: A Retrospective Review of 84 Cases With a Minimum 3-Year Follow-Up

Cottom, James M.; Graney, Colin; Sisovsky, Charles

doi:10.1053/j.jfas.2019.12.011

Cited by 13 publications

(17 citation statements)

References 26 publications

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“…Cottom et al 10 also reported using an additional intercuneiform screw. They reported the subsequent removal of the intercuneiform screw in 9 of their patients, secondary to loosening or residual pain.…”

Section: Discussionmentioning

confidence: 99%

“…Several studies, from as early as 2008, have reported the successful stabilization of Lisfranc injuries using the Arthrex Mini-TightRope system. 4 , 5 , 7 , 10 , 11 , 19 This study reports a technique of drilling from the base of the second metatarsal to the medial cuneiform. This places the oval button over the medial cuneiform, instead of the second metatarsal.…”

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

“…3 Although limited to small case series, several studies utilizing suture buttons have reported satisfactory results, achieving stable fixation of the Lisfranc joint and allowing early return to weightbearing while eliminating further surgery to remove the hardware. 4,[7][8][9][10][11][12]19,37 The objective of this study was to assess the efficacy of this knotless interosseous suture button device to repair purely ligamentous Lisfranc injuries in elite athletes. We hypothesized that this device would allow for an accelerated and predictable rehabilitation protocol resulting in earlier RTP as well as avoiding a second operation for hardware removal.…”

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confidence: 99%

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Shortening the Return-to-Play Times in Elite Athletes With Unstable Isolated Lisfranc Ligament Injuries Using a Knotless Interosseous Suture Button: Case Series and Literature Review

Sullivan

Peckston

Alpuerto

2022

Orthopaedic Journal of Sports Medicine

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Background: Isolated unstable Lisfranc ligament injuries in elite athletes are associated with a lengthy period of rehabilitation and prolonged absence from competition. Purpose: To assess the efficacy of a knotless, interosseous suture button system for repairing isolated unstable ligamentous Lisfranc injuries and its capacity to allow accelerated rehabilitation with earlier weightbearing and return-to-play times in elite athletes. Study Design: Case series; Level of evidence, 4. Methods: The authors retrospectively reviewed data from a prospectively compiled database for elite athletes treated by a single surgeon. All included patients had clinical and magnetic resonance imaging evidence of an unstable isolated complete ligamentous Lisfranc injury requiring surgical reduction and stabilization. All patients underwent surgery using a knotless interosseous suture button to achieve stabilization, followed by a standardized postoperative regimen involving full weightbearing at 4 weeks, and all had a minimum postoperative follow-up of 2 years. Results: Included were 12 patients: 7 National Rugby League (NRL) players, 2 professional dancers, 1 Olympic gymnast, 1 professional wakeboarder, and 1 professional NRL referee. The mean age of the patients was 21.1 years (range, 16-34 years). Ten patients underwent acute surgical stabilization within 3 weeks of the injury, and 2 patients sustained chronic isolated Lisfranc instability that was initially treated nonoperatively. All athletes were able to return to full weightbearing by 4 weeks postoperatively, successfully returned to training by 9 to 12 weeks, and returned to full competition by 12 to 16 weeks. No major complications were reported. Conclusion: Knotless interosseous suture button stabilization was a reliable treatment option for both acute and chronic isolated ligamentous Lisfranc injuries in these elite athletes. This technique does not require hardware removal, allows early weightbearing with accelerated rehabilitation, and may shorten the return-to-play interval.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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confidence: 99%

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confidence: 99%

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Shortening the Return-to-Play Times in Elite Athletes With Unstable Isolated Lisfranc Ligament Injuries Using a Knotless Interosseous Suture Button: Case Series and Literature Review

Sullivan

Peckston

Alpuerto

2022

Orthopaedic Journal of Sports Medicine

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“…One study identified this in a few patients at 3 years postoperatively with ligamentous Lisfranc injuries, although they speculated that such small diastases may be a result of imperfect radiographic positioning. 5 In addition, no studies have yet to demonstrate that this technique is associated with a reduced risk of posttraumatic osteoarthritis compared with plate or transarticular screw fixation.…”

Section: Video Transcriptmentioning

confidence: 99%

Flexible Fixation Technique for Subtle Lisfranc Injuries

Harlow

Vakharia

Alexeev

et al. 2022

Video Journal of Sports Medicine

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Background: Subtle Lisfranc injuries represent a primarily ligamentous Lisfranc complex injury involving the Lisfranc ligament and the medial and middle cuneiform ligaments. Static radiographic displacement or dynamic instability of the medial cuneiform and 2nd metatarsal typically warrants operative intervention to prevent chronic functional pain, allow for timely return-to-sport, and mitigate posttraumatic osteoarthritis. Flexible fixation techniques offer a unique solution to the issues seen with transarticular screws, plates, and arthrodesis for ligamentous Lisfranc injuries. Indications: We present the case of a 16-year-old female basketball player with a subtle Lisfranc injury sustained during practice. X-rays show isolated widening of the 1st and 2nd metatarsal bases and dynamic diastasis between the medial and middle cuneiforms. Magnetic resonance imaging (MRI) confirmed a rupture of the plantar Lisfranc ligament. After extensive discussion regarding treatment options, the patient and her family decided to proceed with surgical intervention using a suture anchor and button technique to restore stability to the Lisfranc ligament and intercuneiform complexes. Technique Description: A standardized dynamic examination under anesthesia identifies the extent of the injury. Exposure of the base of the 2nd metatarsal and medial cuneiform is performed. Reduction clamps are applied to restore the intercuneiform relationship and interval between the medial cuneiform and base of 2nd metatarsal. The suture anchor and button construct is placed using fluoroscopic guidance. A final dynamic examination is performed to confirm stability of the construct. Results: Biomechanical studies have shown that flexible fixation maintains physiologic motion about the Lisfranc articulations and has comparable stability to transarticular screws in cadaveric models of isolated Lisfranc ligament insufficiency. Clinical results are limited but demonstrate excellent postoperative functional outcome scores with very few fixation-related complications at 1 to 3 years. Discussion: Flexible fixation techniques for subtle Lisfranc injuries offer unique benefits to transarticular screws, plates, and arthrodesis. We highlight the appropriate evaluation of patients with a suspected subtle ligamentous Lisfranc injury, the surgical technique using a suture button and anchor construct, and review postoperative management and expected outcomes based on the present literature.

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Superiority of upper ankle arthrodesis over total ankle replacement in the treatment of end-stage posttraumatic ankle arthrosis

Fischer

Klug

Faul

et al. 2021

Arch Orthop Trauma Surg

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Treatment of Lisfranc Injuries Using Interosseous Suture Button: A Retrospective Review of 84 Cases With a Minimum 3-Year Follow-Up

Cited by 13 publications

References 26 publications

Shortening the Return-to-Play Times in Elite Athletes With Unstable Isolated Lisfranc Ligament Injuries Using a Knotless Interosseous Suture Button: Case Series and Literature Review

Shortening the Return-to-Play Times in Elite Athletes With Unstable Isolated Lisfranc Ligament Injuries Using a Knotless Interosseous Suture Button: Case Series and Literature Review

Flexible Fixation Technique for Subtle Lisfranc Injuries

Superiority of upper ankle arthrodesis over total ankle replacement in the treatment of end-stage posttraumatic ankle arthrosis

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