Ilizarov frame delayed internal fixation of Lisfranc fracture dislocation with severe soft tissue injury: New technique

Abstract

We describe a new technique of temporary stabilisation of a divergent Lisfranc fracture dislocation of foot with severe crush injury using an Ilizarov frame. A 69-year-old man presented with severe crush injury and complete disruption of the midfoot. Examination revealed full thickness skin necrosis, haemorrhagic blisters and extensive swelling. A staged technique was used with temporary application of an Ilizarov frame followed by delayed limited internal fixation. Excellent result was achieved with restoration of medial arch, complete pain relief and good functional outcome. A staged treatment initially using an Ilizarov frame prior to limited internal fixation allows soft tissue to settle in severe crush injury.

Soft Tissue Management in a Lisfranc Fracture- Dislocation Case

“…Lisfranc fracture dislocation describes a range of injuries, from occult fractures/ligamental injuries to open crush injuries with extensive bone/soft tissue damage [10]. Early diagnosis of a Lisfranc injury is important to achieve anatomic reduction which is the most important surgical parameter to avoid long term complications [8].…”