Fractures and fracture-dislocations of the tarsometatarsal joint.

Arntz, Craig T.; Veith, Robert G.; Hansen, Sigvard T.

doi:10.2106/00004623-198870020-00003

Cited by 286 publications

(220 citation statements)

References 0 publications

Supporting

Mentioning

199

Contrasting

Unclassified

Order By: Relevance

“…Open reduction and internal fixation (ORIF) with transarticular screw fixation has long been considered the gold standard [10]. The placement of transarticular screws arguably further damages the articular surfaces of the involved joints.…”

Section: Open Reduction Internal Fixationmentioning

confidence: 99%

Lisfranc injuries

Clare

2017

Curr Rev Musculoskelet Med

View full text Add to dashboard Cite

show abstract

Section: Open Reduction Internal Fixationmentioning

confidence: 99%

Lisfranc injuries

Clare

2017

Curr Rev Musculoskelet Med

View full text Add to dashboard Cite

show abstract

“…There is little support provided to the dorsal surface of the tarsometatarsal joint. 3,4 As a result of this configuration, when the foot is positioned in extreme plantar-flexion, the second metatarsal is prone to dislocate dorsally if an axial load is applied. Because of the keystone configuration of the base of the second metatarsal and the strength of the Lisfranc ligament, a fracture at the base of the second metatarsal is commonly observed with a Lisfranc dislocation.…”

Section: Discussionmentioning

confidence: 99%

“…2 They occur most commonly as a result of a motor vehicle accident. 4 Rarely have they been described as a result of participation in sports activities. The annual incidence is estimated to be 1 in 55,000 persons per year.…”

Section: Discussionmentioning

confidence: 99%

“…The physician should also continue to look for this fracture-dislocation when interpreting radiographs, as it has been estimated that 20% of Lisfranc joint injuries are missed on initial radiography. 2,4,12 These studies should include weightbearing anteroposterior, lateral, and oblique radiographs of the foot because non-weight-bearing views of the foot can be normal.…”

Section: Dotted Lines) a 2-mm Diastasis Is Noted Between The Medial mentioning

confidence: 99%

“…Even though there is little consensus regarding the correlation of long-term outcome to the degree of diastasis between the first two metatarsal heads, current management options are based on the concept that more satisfactory results will ensue from a stable, anatomic reduction of the fracture-dislocation. 2,4,12 Most investigators have concluded that there is little place for the nonoperative management of Lisfranc fracture-dislocations when a 2-mm or greater diastasis is found between the bases of the first and second metatarsals and medial and middle cuneiforms, because it is difficult to maintain anatomic reduction by closed reduction and immobilization alone. 1,2,4,5,7,9,14,15 Curtis et al 16 recommend surgical reduction for all athletes and active persons.…”

Section: Dotted Lines) a 2-mm Diastasis Is Noted Between The Medial mentioning

confidence: 99%

See 2 more Smart Citations

A Lisfranc Fracture-Dislocation in a Football Player

Harwood¹,

Raikin²

2003

The Journal of the American Board of Family Medicine

View full text Add to dashboard Cite

Injuries to the tarsometatarsal joint, also known as Lisfranc injuries, are uncommon and can be difficult to diagnose. These injuries have a high potential for causing substantial disability related to posttraumatic osteoarthritis. As a result, it is important to be alert for these injuries when evaluating patients after acute foot trauma. This case report describes a collegiate athlete with a Lisfranc fracture-dislocation. Relevant aspects of the physical examination, diagnostic imaging, and treatment considerations are discussed. Case ReportThe patient, a 22 year-old male collegiate football player, was examined on the field after sustaining an injury to his right foot. After falling on a plantarflexed, fixed foot, an axial load was applied to the posterior aspect of the patient's right heel. He developed immediate pain and swelling over the dorsum of the foot, and he was unable to bear weight on his foot. His medical and surgical history were unremarkable.When the patient was examined, he was in extreme discomfort. He had considerable swelling over the dorsum of the midfoot. His foot was diffusely tender with areas of maximal tenderness over the first and second tarsometatarsal joints, the medial cuneiform, and between the first and second metatarsal heads. The foot was otherwise neurologically intact.The patient was sent to the local emergency department for radiographs immediately after the injury. Non-weight-bearing anteroposterior, lateral, and oblique radiographs were obtained. The physicians caring for the patient in the emergency department, including the on-call radiologist, did not observe any abnormalities on the initial films. The patient was released from the emergency department with crutches and a postoperative shoe. He was told that he had a severe sprain of his foot. When the patient brought the radiographs to the training room the next day, a fracture of the medial cuneiform was seen in addition to 2 mm of widening between the medial and middle cuneiform articulation, findings consistent with a Lisfranc fracture-dislocation (Figure 1). The patient's foot was placed in a fracture boot, and he was assigned to strict non-weight-bearing status. He was then referred to a foot and ankle surgeon, who took him to the operating room 4 days after the injury for open reduction and internal fixation of both the medial cuneiform fracture and the Lisfranc dislocation. A cannulated screw was placed from the medial aspect of the medial cuneiform across the Lisfranc articulation into the base of the second metatarsal. A second screw was placed across the medial cuneiform into the middle cuneiform (Figure 2). The patient was instructed to remain non-weight bearing, and his foot was put in a cast to immobilize it. He was then given a fracture boot to wear for 6 weeks. He was gradually weaned from his fracture boot without difficulty. The hardware was removed 19 weeks after surgery. At 42 weeks after surgery and 22 weeks after removal of the screws, the patient was asymptomatic and was given permission to partic...

show abstract