A Biomechanical Analysis of a Tensioned Suture Device in the Fixation of the Ligamentous Lisfranc Injury

Abstract

Abduction stress may be valuable when diagnosing and testing the transverse ligamentous Lisfranc injury. Both suture-button and screw fixation methods restrain motion at the Lisfranc complex.

Efficacy of open reduction and internal fixation with a miniplate and hollow screw in the treatment of Lisfranc injury

“…In some cases an injured ligament may occur, but it is difficult to predict. 21 Ligament rupture is often repaired by scar tissue, which has poor tensile resistance as well as wear resistance, and can easily cause ligament re-rupture and makes the joint unstable. 22 So our patients were treated with hollow screws inserted from the medial cuneiform to the second metatarsal bone base and another one inserted from the fifth metatarsal base to the cuboid, to enhance the strength of the Lisfranc ligament and to maintain the anatomical reduction.…”

Lisfranc Injuries

“…9,47,48 Recent studies have confirmed equivalent stability across the Lisfranc joint when using a suture button device as compared with screw fixation. 49,50 Even so, suture button devices should be used with extreme caution, as multi-plane instability cannot be adequately stabilized with flexible fixation. If any instability in the sagittal plane is noted on preoperative or intraoperative imaging, the authors recommend a screw for fixation after reduction of the Lisfranc complex.…”

Dual TightRope Fixation for Subtle Lisfranc Injuries

“…10 These injuries are 3 dimensional requiring stabilization not only to prevent widening but to address rotation as well. 12,13 Adding a second TightRope to the construct adds stability by addressing rotation and medial-lateral compression. 9,11 Biomechanical cadaveric comparisons of screw versus single TightRope fixation have shown conflicting results.…”