Anatomical Pathology of Subtle Lisfranc Injury

Haraguchi, Naotsugu; Ota, Koki; Ozeki, Takuma; Nishizaka, Shingo

doi:10.1038/s41598-019-51358-8

Cited by 21 publications

(28 citation statements)

References 21 publications

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“…3,8 Nevertheless, because of the biomechanical importance of the Lisfranc joint as a keystone in the foot arch, even a subtle injury should be classified precisely, followed by adequate management. 14,27,28…”

Section: Introductionmentioning

confidence: 99%

Suture Button vs Conventional Screw Fixation for Isolated Lisfranc Ligament Injuries

et al. 2020

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Background: Suture buttons have been used for isolated Lisfranc ligament (ILL) fixation. However, no study has reported on its clinical and radiologic outcomes. Method: In this retrospective comparative study, patients with ILL injuries were divided into 2 groups according to the treatment method: 32 conventional screw group and 31 suture button group. The clinical and radiologic outcomes at preoperation, 6 months and 1 year postoperation, and last follow-up period were measured. Plantar foot pressure was measured at postoperative month 6 months. Postoperative complications at the last follow-up were evaluated. Result: The suture button group showed better American Orthopaedic Foot & Ankle Society midfoot scale ( P < .001) and visual analog scale ( P < .001) scores compared with the conventional screw fixation group at the postoperative month 6 period before screw removal. However, no significant difference in clinical outcome between the 2 groups was found at postoperative year 1 or last follow-up. No differences in radiologic outcomes were found between the 2 groups. Plantar foot pressure was significantly elevated in the conventional screw group at the great toe and first metatarsal head area compared with the contralateral foot just before screw removal. Recurrent Lisfranc joint diastasis was found in a single case in the conventional screw group and 2 cases in the suture button group. Conclusion: Suture button fixation in the treatment of ILL injuries may provide comparable fixation stability and clinical outcome with conventional screw fixation in the early postoperative period. Level of Evidence: Level III, retrospective case-control study, therapeutic.

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Section: Introductionmentioning

confidence: 99%

Suture Button vs Conventional Screw Fixation for Isolated Lisfranc Ligament Injuries

et al. 2020

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“…Patients were intraoperatively determined to have had an unstable Lisfranc joint if the dorsal ligament(s) were ruptured and any diastases or subluxation was seen after gently inserting a small freer elevator into the joint. 8,9 Furthermore, the intercuneiform joint (C1-C2) was deemed unstable if the dorsal intercuneiform ligament was ruptured with any diastasis or subluxation. 8,10 These patients received surgical fixation of the Lisfranc joint complex as part of their clinical course.…”

Section: Study Population and Designmentioning

confidence: 99%

“…8,9 Furthermore, the intercuneiform joint (C1-C2) was deemed unstable if the dorsal intercuneiform ligament was ruptured with any diastasis or subluxation. 8,10 These patients received surgical fixation of the Lisfranc joint complex as part of their clinical course.…”

Section: Study Population and Designmentioning

confidence: 99%

Using area and volume measurement via weightbearing CT to detect Lisfranc instability

Bhimani

Sornsakrin

Ashkani-Esfahani

et al. 2021

Journal Orthopaedic Research

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Weightbearing CT (WBCT) allows evaluation of the Lisfranc joint under physiologic load. We compared the diagnostic sensitivities of one-dimensional (1D) distance, two-dimensional (2D) area, and three-dimensional (3D) volumetric measurement of the injured Lisfranc joint complex (tarsometatarsal, intertarsal, and intermetatarsal) on WBCT among patients with surgically-confirmed Lisfranc instability. The experimental group comprised of 14 patients having unilateral Lisfranc instability requiring operative fixation who underwent preoperative bilateral foot and ankle WBCT. The control group included 36 patients without foot injury who underwent similar imaging. Measurements performed on WBCT images included: (1) Lisfranc joint (medial cuneiform-base of second metatarsal) area, (2) C1-C2 intercuneiform area, (3) C1-M2 distance, (4) C1-C2 distance, (5) M1-M2 distance, (6) first tarsometatarsal (TMT1) angular alignment, (7) second tarsometatarsal (TMT2) angular alignment, (8) TMT1 dorsal step off distance, and (9) TMT2 dorsal step-off distance.In addition, the volume of the Lisfranc joint in the coronal and axial plane were calculated. Among patients with unilateral Lisfranc instability, all WBCT measurements were increased on the injured side as compared to the contralateral uninjured side (p values: <.001-.008). Volumetric measurements in the coronal and axial plane had a higher sensitivity (92.3%; 91.6%, respectively) and specificity (97.7%; 96.5%, respectively) than 2D and 1D Lisfranc joint measurements, suggesting them to be the most accurate in diagnosing Lisfranc instability. The control group showed no difference in any of the measurements between the two sides. WBCT scan can effectively differentiate between stable and unstable Lisfranc injuries. Lisfranc joint volume measurements demonstrate high sensitivity and specificity, suggesting that this new assessment has high clinical implications for diagnosing subtle Lisfranc instability.

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“…One rare subtype of Lisfranc injury is traumatic instability of the first ray being described only in a few case reports. If unrecognised, this injury can lead to significant morbidity with an unstable first ray, midfoot instability, arthritis, and midfoot collapse 2,3 .…”

Section: Introductionmentioning

confidence: 99%

Ligamentous instability of the first ray: A case report introducing the naviculocuneiform kissing sign on MRI scan

Vather

Nguyen

Ghasemzadeh

et al. 2022

Foot & Ankle Surgery: Techniques, Reports & Cases

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This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

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Anatomical Pathology of Subtle Lisfranc Injury

Cited by 21 publications

References 21 publications

Suture Button vs Conventional Screw Fixation for Isolated Lisfranc Ligament Injuries

Suture Button vs Conventional Screw Fixation for Isolated Lisfranc Ligament Injuries

Using area and volume measurement via weightbearing CT to detect Lisfranc instability

Ligamentous instability of the first ray: A case report introducing the naviculocuneiform kissing sign on MRI scan

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