Injuries to the tarsometatarsal joint. Incidence, classification and treatment

Hardcastle, P. H.; Reschauer, R.; Kutscha-Lissberg, E; Schöffmann, W

doi:10.1302/0301-620x.64b3.7096403

Cited by 410 publications

(258 citation statements)

References 5 publications

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“…The optimal method for fixating arthrodeses of the Lisfranc's joint complex should ideally provide stability, with high compression ability and minimal surgical aggression (2,5) . Stabilization with Kirshner's wires, despite being easier, does not provide proper compression, and the use of plates and screws has as a disadvantage a high degree of surgical aggression, and, in some patients, postoperative discomfort, sometimes requiring removal of the synthesis material after procedure consolidation (8,11) .…”

Section: Discussionmentioning

confidence: 99%

“…At the initial X-ray evaluation, only 40% of the injuries are diagnosed due to subdislocations, spontaneous reductions and non-compromised isolated ligament injuries (2,3) . Treatment fundamentals are as follows: early diagnosis, anatomic joint reduction and stable bone fixation, thus minimizing additional damages to soft tissues and to joint cartilage (4) .…”

Section: Introductionmentioning

confidence: 99%

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Estabilização da artrodese da articulação tarsometatársica: estudo biomecânico

et al. 2008

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INTRODUÇAO: As artrodeses tarsometatársicas sao opçao terapeutica efetiva no tratamento das osteoartroses sintomaticas da articulacao de Lisfranc. Os métodos de estabilizaçao disponíveis sao: Fios de Kirschner, Parafusos Corticais, Placas e parafusos e Agrafe. A estabilidade oferecida e a técnica cirúrgica utilizada para cada material é discutida na literatura. OBJETIVO: Comparar a força de compressão e a estabilidade biomecânica da fixação da articulação tarsometatársica com Parafusos Corticais e com Agrafe. CASUISTICA E MÉTODO: Selecionados 10 cadáveres frescos, do genero masculino, idade variando de 35 a 49 anos, foram submetidas a dissecçao do cúboide e do 4° metatarso bilateralmente, decorticadas as superfícies articulares e realizada fixação com parafuso cortical - Cortical Screw 3.5mm Impol, e Agrafe - Uni-clip® Staple 2.0 NewDeal. RESULTADOS: Os 20 ensaios biomecânicos foram completados. A analise estatística dos métodos agrafe vs parafuso cortical, em relação a energia acumulada até atingir o pico de força do ensaio p= 0.047, e a energia acumulada até o final do ensaio p= 0.047 apresentaram diferença significativa. CONCLUSÃO: Os picos de carga suportados pelas estabilizaçoes com agrafe e com parafuso cortical decrescem, significativamente, com a idade. Observa-se valores de força superiores para o agrafe em ossos osteoporóticos. A energia acumulada na area de trabalho dos graficos nos ensaios com o agrafe, mostram-se estatisticamente superiores aos valores para os Parafusos Corticais.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Estabilização da artrodese da articulação tarsometatársica: estudo biomecânico

et al. 2008

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“…The annual incidence is estimated to be 1 in 55,000 persons per year. 5,6 It is important to diagnose these injuries early and initiate appropriate treatment. The most common long-term complication of a Lisfranc joint injury is chronic pain secondary to posttraumatic osteoarthritis, particularly if the congruency and stability of the Lisfranc articulation are not reestablished.…”

Section: Discussionmentioning

confidence: 99%

A Lisfranc Fracture-Dislocation in a Football Player

Harwood¹,

Raikin²

2003

The Journal of the American Board of Family Medicine

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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...

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“…The Lisfranc joint, also referred to as the tarsometatarsal (TMT) joint complex, is named after Jacques Lisfranc (1790-1847), a 1,2 French surgeon . Lisfranc injury is commonly used to describe injuries at the bases of the five metatarsals (MTs), their articulations with the four distal tarsal bones, and the Lisfranc ligament.…”

Section: Introductionmentioning

confidence: 99%

“…Lisfranc ligament is a strong interosseous attachment located between the medial cuneiform and the second MT. 2 Lisfranc injuries account for 0.2% of all fractures . The reported incidence of this uncommon injury is approximately 1 per 55,000 persons per year.…”

Section: Introductionmentioning

confidence: 99%

Results of Displaced Lisfranc Injuries with Open Reduction and Fixation with K-Wires

Shrestha

Dhungel

Lakhanpal

et al. 2017

J. Nepalgunj Med. College

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Background:The Lisfranc injury is an injury of the foot in which one or more metatarsal bones are displaced from the tarsal bones. Due to their low incidence and complexity, these injuries are often missed on initial evaluation. Prompt recognition and then anatomic reduction and stabilization gives best outcomes post treatment. Aim: The study aimed to compare short-term treatment results for tarso-metatarsal joint injuries with treatment outcomes and compare it with type of injury per classification. Methods: This was a prospective observational, analytical hospital based study. The subjects included in the study were classified according to radiological findings and treated with open reduction and K-wire fixation. Study subjects were immobilized for six weeks. Weight bearing was progressed slowly. Short term result was calculated by American orthopaedic foot and ankle society score (AOFAS) at six months. Results: Of the nine cases included in the study, low energy fall, five (55.55%) was commoner cause for injury followed by high energy road traffic accident (RTA) in four (44.44%) patients. Six fractures (66.67%) were of type A while, three (33.3%) were type B. Average day from injury to surgery was 3.11 (range 2-5). AOFAS Score calculated in six months average was 82.44(SD±12.79). In patients with type A injury mean AOFAS score was 89(SD+-2.6), while in patients with type B injury had mean of 69.33(SD±15.82). The AOFAS score difference for the group A and B was statistically significant (P<0.05). Conclusions: Lisfranc injuries are life changing injuries as scores of AOFAS get lower even after 6 months of injury. Patients with type B injuries have poorer outcome than type A injuries.

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Injuries to the tarsometatarsal joint. Incidence, classification and treatment

Cited by 410 publications

References 5 publications

Estabilização da artrodese da articulação tarsometatársica: estudo biomecânico

Estabilização da artrodese da articulação tarsometatársica: estudo biomecânico

A Lisfranc Fracture-Dislocation in a Football Player

Results of Displaced Lisfranc Injuries with Open Reduction and Fixation with K-Wires

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