Biomechanical comparison of fixation stability using a Lisfranc plate versus transarticular screws

Ho, Nathan C.; Sangiorgio, Sophia N.; Cassinelli, Spenser J.; Shymon, Stephen; Fleming, John F.; Agrawal, Virat; Ebramzadeh, Edward; Harris, Thomas J.

doi:10.1016/j.fas.2017.08.004

Cited by 24 publications

(22 citation statements)

References 21 publications

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“…e screw internal fixation effect is good, and it can solve the shortcomings of the poor stability of Kirschner wire fixation, but it is easy to cause damage to the articular cartilage surface and cause traumatic arthritis [11,12]. e steel plate internal fixation not only has a fixation effect similar to that of screw internal fixation but also avoids damage to the articular surface of the Lisfranc joint to reduce the occurrence of traumatic arthritis [13,14].…”

Section: Introductionmentioning

confidence: 99%

“…The screw internal fixation effect is good, and it can solve the shortcomings of the poor stability of Kirschner wire fixation, but it is easy to cause damage to the articular cartilage surface and cause traumatic arthritis [ 11 , 12 ]. The steel plate internal fixation not only has a fixation effect similar to that of screw internal fixation but also avoids damage to the articular surface of the Lisfranc joint to reduce the occurrence of traumatic arthritis [ 13 , 14 ]. This study aims to explore the curative effect and biomechanical evaluation of three internal fixation methods of Kirschner wire, hollow screw, and steel plate in the treatment of Lisfranc joints injury and to provide corresponding theoretical basis for the choice of clinical internal fixation, in order to improve the efficacy of Lisfranc joint injuries.…”

Section: Introductionmentioning

confidence: 99%

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Clinical Study on Different Methods of Internal Fixation for Treatment of Lisfranc Joint Injury

Jin

Wang

Zhou

2021

Evidence-Based Complementary and Alternative Medicine

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The Lisfranc joints are mainly used to connect the forefoot and midfoot and maintain the stability of the arch of the foot. It is an important part of the arch of the foot. If the Lisfranc joints injury is not treated in time, it will cause poor walking, pain in the back of the foot, and even deformity or disability of the forefoot. The common treatment method is to select the Kirschner wires, screws, or steel plates for incisional repositioning internal fixation surgery. In our study, we used different materials to perform fixation surgery on Lisfranc joint injury patients. We measured the joint recovery, pain condition, complications, and biomechanical indexes of different groups of patients after the operation. The results of the study showed that compared with Kirschner wire and screw internal fixation, the use of shaped arch bridge-type microsteel plate internal fixation for the treatment of metatarsotarsal joint injury patients has better foot function recovery, fewer complications, and more reliable biomechanical strength.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Clinical Study on Different Methods of Internal Fixation for Treatment of Lisfranc Joint Injury

Jin

Wang

Zhou

2021

Evidence-Based Complementary and Alternative Medicine

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“…Low energy tarsometatarsal joint damage is often associated with purely ligamentous Lisfranc injuries. It is difficult to diagnose after injury because the position of Lisfranc ligament is deep [ 2 , 3 ]. Up to about 20–40% of ligamentous Lisfranc injuries are either mis-diagnosed or overlooked during initial evaluation [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

Clinical outcomes of Tightrope system in the treatment of purely ligamentous Lisfranc injuries

et al. 2021

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Background Purely ligamentous Lisfranc injuries are mainly caused by low energy damage and often require surgical treatment. There are several operative techniques for rigid fixation to solve this problem clinically. This study evaluated the effect of using the Tightrope system to reconstruct the Lisfranc ligament for elastic fixation. Methods We retrospectively analyzed 11 cases with purely ligamentous Lisfranc injuries treated with the Tightrope system from 2016 to 2019, including 8 male and 3 female. X-ray was performed regularly after operation to measure the distance between the first and second metatarsal joint and the visual analogue scale (VAS) score was used to evaluate pain relief. American orthopedic foot & ankle society (AOFAS) and Maryland foot score were recorded at the last follow-up. Results The average follow-up time was 20.5 months (range, 17–24). There was statistically significant difference in the distance between the first and second metatarsal joint and VAS score at 3 months, 6 months, and the last follow-up when compared with preoperative values (P < 0.05).Mean of postoperative AOFAS mid-foot scale and Maryland foot score were 92.4 ± 4.3, 94.1 ± 3.5, respectively. The Tightrope system was not removed and the foot obtained better biomechanical stability. No complications occurred during the operation. Conclusion Tightrope system in the treatment of purely ligamentous Lisfranc injuries can stabilize the tarsometatarsal joint and achieve satisfactory effect.

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“…Most of these models only apply axial loading on a plantarflexed foot for their testing. 4,11,12,17 Only Lisfranc injury models that add abduction or adduction stress tests obtain greater joint displacements (4.6 mm). 8,13 No cadaveric models described to the present date include plantarflexion and twisting forces (supination-pronation) trying to reproduce what is suspected to occur in some low-to medium-energy Lisfranc injuries (subtle lesions).…”

Section: Introductionmentioning

confidence: 99%

Biomechanical Evaluation With a Novel Cadaveric Model Using Supination and Pronation Testing of a Lisfranc Ligament Injury

Wagner

Baumfeld

et al. 2020

Foot & Ankle Orthopaedics

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Background: Lisfranc joint injuries can be due to direct or indirect trauma and while the precise mechanisms are unknown, twisting or axial force through the foot is a suspected contributor. Cadaveric models are a useful way to evaluate injury patterns and models of fixation, but a frequent limitation is the amount of joint displacement after injury. The purpose of this study was to test a cadaveric model that includes axial load, foot plantarflexion and pronation-supination motion, which could re-create bone diastasis similar to what is seen in subtle Lisfranc injuries. Our hypothesis was that applying pronation and supination motion to a cadaveric model would produce reliable and measurable bone displacements. Methods: Twenty-four fresh-frozen lower leg cadaveric specimens were used. The medial (C1) and intermediate (C2) cuneiforms and the first (M1) and second (M2) metatarsal bones were marked. A complete ligament injury was performed between C1-C2 and C1-M2 in 12 specimens (group 1), and between C1-C2, C1-M2, C1-M1, and C2-M2 in 12 matched specimens (group 2). Foot pronation and supination in addition to an axial load of 400 N was applied to the specimens. A 3D digitizer was used to measure bone distances. Results: After ligament injury, distances changed as follows: C1-C2 increased 3 mm (23%) with supination; C1-M2 increased 4 mm (21%) with pronation (no differences between groups). As expected, distances between C1-M1 and C2-M2 only changed in group 2, increasing 3 mm (14%) and 2 mm (16%), respectively (no differences between pronation and supination). M1-M2 and C2-M1 distances did not reach significant difference for any condition. Conclusions: Pronation or supination in addition to axial load produced measurable bone displacements in a cadaveric model of Lisfranc injury using sectioned ligaments. Distances M1-M2 and C2-M1 were not reliable to detect injury in this model. Clinical Relevance: This new cadaveric Lisfranc model included foot pronation-supination in addition to axial load delivering measurable bone diastasis. It was a reliable Lisfranc cadaveric model that could be used to test different Lisfranc reconstructions.

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Biomechanical comparison of fixation stability using a Lisfranc plate versus transarticular screws

Cited by 24 publications

References 21 publications

Clinical Study on Different Methods of Internal Fixation for Treatment of Lisfranc Joint Injury

Clinical Study on Different Methods of Internal Fixation for Treatment of Lisfranc Joint Injury

Clinical outcomes of Tightrope system in the treatment of purely ligamentous Lisfranc injuries

Biomechanical Evaluation With a Novel Cadaveric Model Using Supination and Pronation Testing of a Lisfranc Ligament Injury

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