Luxationsfrakturen im Lisfrancschen Gelenk

Abstract

132 injuries of the Lisfranc joint were reviewed in order to show methods of diagnosis and treatment. Injuries of this joint are rare. Almost one third are open fractures and/or dislocations, mostly comminuted lesions, associated with severe soft tissue trauma and so decreasing blood supply of the foot. Most dislocations and fractures can be treated conservatively by closed reductions and following fixation by means of Kirschner wires. In cases of minimal or moderate displacement closed reduction and plaster cast proved to be sufficient. Some cases of severely dislocated fractures or fracture dislocations need open reduction. Closed reduction should never be done when it probably disrupts the blood supply and so causes ischaemia. The methods of conservative or surgical treatment should guarantee best reduction and optimal stability of weight bearing areas of the foot. Operative treatment to achieve accurate reductions does not have definite advantages over conservative methods. Open reduction is recommended in all cases of delayed treatment, if blood supply is intact and the patient is young. Inveterate cases with poor results require special shoes or an orthosis and only sometimes osteotomies and other reconstructive operations.

Die Korrekturarthrodese bei isolierten posttraumatischen Fehlstellungen im Subtalargelenk

“…Die erfolgreiche Korrekturarthrodese des subtalaren Gelenks ermo È glicht dabei einen schmerzfreien plantigraden Auftritt des Fuûes mit relativ normalem Gangbild [2,3,7,13]. Dies beginnt bei der umfassenden ko È rperlichen Untersuchung gerade von Polytraumatisierten, bei denen Verletzungen des Fuûes leicht u È bersehen werden [3,9,11,12] und endet bei der fru È hestmo È glichen Reposition der Fraktur, meist operativ. Unabha È ngig davon ist auch bei einem exzellenten operativen Ergebnis die ko È rperliche Aktivita È t des Patienten eingeschra È nkt (z.…”