Gait analysis and functional outcome in patients after Lisfranc injury treatment

Hoeve, Sander van; Stollenwerck, Guido; Willems, P; Witlox, M.A.; Meijer, Kenneth; Poeze, Martijn

doi:10.1016/j.fas.2017.07.003

Cited by 20 publications

(25 citation statements)

References 42 publications

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“…The use of trans articular screws or a primary arthrodesis has never been considered in knee or shoulder ligament injuries, and, in that way, why should they be considered in a joint with movement and with an important biomechanical property in the foot? After Lisfranc injuries, patients have altered gait compared with healthy subjects (9). When gait analysis is performed in patients who have had a Lisfranc stabilization with trans articular screws or arthrodesis, they show a significantly lower walking speed and significantly decreased flexion/ extension in the midfoot during push-off phase.…”

Section: Discussionmentioning

confidence: 99%

“…This could indicate that in the post-operative phase a high flexion-extension motion is important for patient satisfaction. Even in patients where hardware was removed before gait analysis, they still presented a non-functional gait (9,20). This last fact highlights the need of finding a reliable, functional and non-rigid reconstruction of midfoot injuries.…”

Section: Discussionmentioning

confidence: 99%

“…Arthrodesis eliminate normal motion of theses joints and may overload the adjacent joint. In a recent study, it was proved that patients who were treated with arthrodesis or plate/screw fixation had significantly lower walking speed and significantly decreased flexion/extension in the midfoot during the push-off phase (9). This is a functional demonstration of the limitations that could occur after this type of treatment.…”

Section: Introductionmentioning

confidence: 97%

See 2 more Smart Citations

Dynamic Lisfranc Joint Repair Concept: Surgical Technique for a Synthetic Neoligamentplasty

Nery

Giza

Wagner

et al. 2019

Muscle Ligaments and Tendons J

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Background. Isolated Lisfranc ligament and some other combined ligament injuries to the Lisfranc Joint Complex are frequently found in clinical practice, and surgical treatment is commonly indicated. In order to achieve favorable outcomes following the repair of Lisfranc injuries, a successful anatomical reduction is required. Various fixation methods currently exist such as screw fixation, dorsal bridge plate fixation, K-wire stabilization, primary fusion, neoligamentplasty and TightRope stabilization. Each technique has its own advantages and disadvantages. any rigid and long immobilization of a ligament is detrimental to healing and compromises its mechanical properties. Ideally, the best form to treat an articular joint involvement is to use a long-lasting implant, with flexibility that could potentially provide the proper stability allowing enough motion to achieve a more physiologic ligament healing. We describe a novel technique to reconstruct the Lisfranc injuries with pure ligament disruption using a synthetic neoligamentplasty with FiberTape-InternalBrace™ (Arthrex, Naples, FL) passed through anatomic bone tunnels that mimic the original isometric position of the ligaments. Methods. We described the technique and evaluated 7 consecutive patients with midfoot ligament injury and a combination of tarsometatarsal instability and/or intercuneiform instability. Results. We found no postoperative complications, stiffness, or loss of correction. Conclusions. The innovative surgical technique present in this article is effective and eliminates the need for subsequent implant removal for lisfranc joint injuries. It could also provide a more physiologic arch deformation to interact with the environment in a more effective way, protecting the surrounding joints from excessive loads.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 97%

See 1 more Smart Citation

Dynamic Lisfranc Joint Repair Concept: Surgical Technique for a Synthetic Neoligamentplasty

Nery

Giza

Wagner

et al. 2019

Muscle Ligaments and Tendons J

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“…Significant differences were found between the two groups in terms of joint balance in the midfoot during the take-off phase (push-off) in the sagittal plane (flexion/extension). 30…”

Section: Resultsmentioning

confidence: 99%

Lisfranc fracture-dislocations: current management

Moracia-Ochagavía¹,

Rodríguez-Merchán²

2019

EFORT Open Reviews

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It is essential to know and understand the anatomy of the tarsometatarsal (TMT) joint (Lisfranc joint) to achieve a correct diagnosis and proper treatment of the injuries that occur at that level. Up to 20% of Lisfranc fracture-dislocations go unnoticed or are diagnosed late, especially low-energy injuries or purely ligamentous injuries. Severe sequelae such as post-traumatic osteoarthritis and foot deformities can create serious disability. We must be attentive to the clinical and radiological signs of an injury to the Lisfranc joint and expand the study with weight-bearing radiographs or computed tomography (CT) scans. Only in stable lesions and in those without displacement is conservative treatment indicated, along with immobilisation and initial avoidance of weight-bearing. Through surgical treatment we seek to achieve two objectives: optimal anatomical reduction, a factor that directly influences the results; and the stability of the first, second and third cuneiform-metatarsal joints. There are three main controversies regarding the surgical treatment of Lisfranc injuries: osteosynthesis versus primary arthrodesis; transarticular screws versus dorsal plates; and the most appropriate surgical approach. The surgical treatment we prefer is open reduction and internal fixation (ORIF) with transarticular screws or with dorsal plates in cases of comminution of metatarsals or cuneiform bones. Cite this article: EFORT Open Rev 2019;4:430-444. DOI: 10.1302/2058-5241.4.180076

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“…The investigators found a significantly lower walking speed and a significantly decreased range of motion of the midfoot during the push-off phase. 16…”

Section: Introductionmentioning

confidence: 99%

Comparison of Suture-Augmented Ligamentplasty to Transarticular Screws in a Lisfranc Cadaveric Model

Nery

Baumfeld

et al. 2020

Foot Ankle Int.

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Background: Lisfranc injuries represent a spectrum of trauma from high-energy lesions, with significant instability of the midfoot, to low-energy lesions, with subtle subluxations or instability without gross displacement. Recently, treatment options that allow for physiologic fixation of this multiplanar joint are being evaluated. The purpose of this study was to analyze the stability of a cadaveric Lisfranc injury model fixed with a novel suture-augmented neoligamentplasty in comparison with a traditional transarticular screw fixation construct. Methods: Twenty-four fresh-frozen, matched cadaveric leg and foot specimens (12 individuals younger than 65 years of age) were used for this study. Two different types of Lisfranc ligament injuries were tested: partial and complete. Two different methods of fixation were compared: transarticular screws and augmented suture ligamentplasty with FiberTape. Specimens were fixed to a rotation platform in order to stress the joints while applying 400 N of axial load and internal and external rotation. Six distances were measured and compared between the intact, injured, and fixed states with a 3D Digitizer arm, in order to evaluate the stability between them. Analysis of variance was used with P < .05 considered significant. Results: Using distribution graphs and analyzing the grouped data, it was observed that there was no difference between the 2 stabilization methods, but the augmented suture ligamentplasty presented lower variability and observed distance shortenings were more likely to be around the mean. The variability of the stabilization with screws was 2.9 times higher than that with tape ( P < .001). Conclusion: We suggest that augmented suture ligamentplasty can achieve similar stability to classic transarticular screws, with less variability. Clinical Relevance: This cadaveric study adds new information on the debate about Lisfranc lesions treatment. Flexible fixations, such as the synthethic ligamentplasty used, can restore good stability such as conventional transarticular screws.

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Gait analysis and functional outcome in patients after Lisfranc injury treatment

Cited by 20 publications

References 42 publications

Dynamic Lisfranc Joint Repair Concept: Surgical Technique for a Synthetic Neoligamentplasty

Dynamic Lisfranc Joint Repair Concept: Surgical Technique for a Synthetic Neoligamentplasty

Lisfranc fracture-dislocations: current management

Comparison of Suture-Augmented Ligamentplasty to Transarticular Screws in a Lisfranc Cadaveric Model

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