Verletzungen der Fußwurzel

Mittlmeier, Thomas; Beck, Markus

doi:10.1007/s10302-007-0280-2

Cited by 7 publications

(4 citation statements)

References 27 publications

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“…An alternative approach would be a dorsomedian approach between the tendons of the flexor hallucis longus and brevis muscles; in this case, the lateral approach should be in line with the fifth metatarsal. In both cases, a minimum horizontal distance between the two incisions of around 5 cm should be maintained to minimize the risk of skin flap necrosis [3,8,9,11,13,14]. Independent of the approach variant used, the neurovascular bundle lateral to the extensor hallucis longus tendon with the dorsalis pedis artery and the terminal branches of the deep peroneal nerves as well as the lateral tarsal artery should be preserved [9].…”

Section: Surgical Techniquesmentioning

confidence: 99%

“…In particular, combination injuries of the Chopart and Lisfranc joint lines have a guarded prognosis as even anatomic reduction may not guarantee a good functional outcome. At the present time, between 20 and 40% of all Lisfranc joint lesions are not diagnosed initially, although they may be detected later due to persistent pain, instability, or even progressive deformity and osteoarthritis [4][5][6][7][8][9][10][11][12][13]. In particular, purely ligamentous lesions of the medial Lisfranc joints may be misinterpreted as sprains, leading invariably to permanent functional deficits [4,6,14,15].…”

Section: Introductionmentioning

confidence: 99%

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Reconstruction After Malunited Lisfranc Injuries

2010

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Symptomatic secondary osteoarthritis of the Lisfranc joints due to malunion following Lisfranc joint fracture dislocations or ligamentous lesions at the Lisfranc and innominate joint level generally lead to a painful functional loss and a substantial disturbance of the walking performance. Initially missed or inadequately addressed primary lesions still represent the major source of Lisfranc joint malunions. Neuro-osteoarthropathic disorders may also become manifest in the Lisfranc joint region and may be mistaken for truly posttraumatic consequences. Secondary osteoarthritis may be combined with typical multiplanar deformities. The concept of a corrective arthrodesis includes restoration of stable physiologic axes and length proportions of the foot columns. A standardized approach to analyze the clinical picture and corresponding pathomorphology and the transfer into a comprehensive surgical concept which respects the realignment of any component of deformity is a prerequisite for a good functional outcome and a high degree of patient satisfaction. A fusion limited to the medial three rays combined with a soft tissue release may be sufficient for a favorable outcome in the majority of cases and preserve the mobility of the two lateral rays.

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Section: Surgical Techniquesmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Reconstruction After Malunited Lisfranc Injuries

2010

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“…Minimale Subluxationen werden auch in der 45° Schrägaufnahme gut erkannt. Hier sind zudem alle 4 Knochen, die die Chopart-Gelenkreihe bilden, überlagerungsfrei dargestellt und können somit gut auf Frakturzeichen untersucht werden [11,13,16].…”

Section: Bildgebung Radiologische Diagnostikunclassified

“…Hierbei gilt als Grundprinzip, dass F die 2-Säulen-Statik anatomisch wiederhergestellt, F die entsprechenden Gelenkflächen exakt ausgerichtet und F ligamentäre Instabilitäten behandelt werden müssen. Zur Wiederherstellung der knöchernen Länge sollte bei Impressionsfrakturen nach Wiederherstellung der Gelenkfläche eine Spongiosaunterfütterung durchgeführt werden [6,13,20]. Die Wahl der Zugänge und Implantate hängt vom Verletzungsmuster ab.…”

Section: Chopart-gelenkunclassified