Stress Fracture of the Second Metatarsal and Sprain of Lisfranc Joint in a Pre-Professional Ballet Dancer

Kriz, Peter K.; Rafferty, Jason; Evangelista, Peter; Valkenburg, Scott Van; DiGiovanni, Christopher W.

doi:10.12678/1089-313x.19.2.80

Cited by 8 publications

(5 citation statements)

References 19 publications

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“…Articles were excluded if they only included studies with adult patients, did not have postoperative follow-up, involved treatments for non-PLI, or included cadaveric studies. This left a total of 10 full text studies 4,5,[7][8][9][10][11][12][13][14] to be used in qualitative synthesis for this systematic review. Figure 1 details the search and selection process for narrowing the initial 290 searched articles to the 10 full-text studies used in this systematic review.…”

Section: Search Resultsmentioning

confidence: 99%

“…4,5 There are many treatment options with varying outcomes, but there is no consensus on the most optimal management protocol for this injury. 1,4,5,[7][8][9][10][11][12][13][14] Nonetheless, the majority of studies included in this systematic review have achieved successful postoperative outcomes using surgical intervention to achieve reduction and fixation in treating PLI. 4,5,[7][8][9][10][11][12][13][14] The purpose of this study is to define standardized diagnostic criteria and novel treatment guidelines based on the classification of injury to pair the best management protocols with optimal long-term outcomes for future patients receiving treatment for PLI.…”

Section: Introductionmentioning

confidence: 99%

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Treatment of paediatric Lisfranc injuries: A systematic review and introduction of a novel treatment algorithm

Paek

Hogue

2022

Journal of Children's Orthopaedics

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Background: Pediatric Lisfranc injuries (PLI) are rare injuries that have few studies published about their occurrence and treatment in pediatric population. Due to this lack of information, the diagnostic criteria and surgical or non-surgical methods for treatment have not been clearly established within the pediatric orthopedic literature. The objective of this study was to review the published literature related to treatment options and develop a concise stepwise treatment algorithm for pediatric patients presenting with Lisfranc injuries. Methods: A systematic literature review was conducted using PubMed to find studies discussing the treatment of PLI with reported long-term outcomes. Data collection accounted for the mechanism of injury, diagnostic imaging modality used, injury type, fracture classification using the Myerson system, treatment method used, and postoperative complications. Results: An initial PubMed search revealed 290 articles, but only 10 studies fulfilled the criteria for in-depth review. A total of 114 patients were included in this review from the selected case reports and case series studies. Primary treatment methods were as follows: 44% (50/114) with open reduction internal fixation (ORIF) using Kirschner wires (K-wires) and/or screws, 3% (3/114) with closed reduction percutaneous fixation (CRPF), 4% (4/114) with suture-button constructs, 20% (23/114) with cast immobilization, and 29% (33/114) were described as not requiring reduction. Conclusion: There were two main limitations to this study. First, there are few published studies with longitudinal outcomes of PLI treatment. Second, some case series did not disclose which procedure a patient with post-treatment complications underwent. Therefore, an overall statistical analysis of success and failure rates with associated complications of each procedure could not be conducted. In conclusion, we found that a stepwise approach to evaluating conservative and surgical treatment options based on the presentation of the PLI should be utilized to optimize long-term outcomes.

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Section: Search Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Treatment of paediatric Lisfranc injuries: A systematic review and introduction of a novel treatment algorithm

Paek

Hogue

2022

Journal of Children's Orthopaedics

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“…These two are considered the strongest ligaments in the Lisfranc ligamentous complex and are the primary stabilizer to the medial and middle column of the midfoot [ 4 , 8 ]. This arrangement allows the foot to perform as a lever arm that propels the foot forward during the gait cycle [ 9 ].…”

Section: Discussionmentioning

confidence: 99%

“…We also note that stress fractures reported in ballet dancers characteristically occur at the base of the second metatarsals [ 19 ]. Whilst acknowledging that Lisfranc ligamentous injury is uncommon in ballet dancers given the en pointe position which imparts compressive rather than shearing force across the TMT joints [ 9 , 20 ], there is paucity of literature on MRI correlate of ballet dancers with second metatarsal base fractures and Lisfranc ligaments in this cohort of patients. This would be an important area of research because the imaging of these second metatarsal base fractures described in literature are quite similar to our cases, involving the plantar Lisfranc footprints at metatarsal bases [ 9 ].…”

Section: Discussionmentioning

confidence: 99%

Lisfranc Sprain with Second Metatarsal Base Adaptive Stress Response in High-Level Athletes: Case Series and Novel Perspective on a Distinct Entity of Chronic Low-Energy Lisfranc Injury

Lim

Heysen²,

Ilic³

et al. 2022

Case Reports in Orthopedics

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Lisfranc injury is increasingly being recognised in the high-performance athletic cohort, particularly in contact sports. In this cohort, there is a pattern of low-energy Lisfranc injury which combines magnetic resonance findings of both ligamentous sprain and adaptive bone stress response that infers a longer timeframe of stress than the duration of symptoms would suggest. This has not been previously described, and the authors believe that this is an unrecognized subset of midfoot sprain in the context of sustained stress to the midfoot. This retrospective case report describes MRI findings of three index cases of this entity in professional athletes presenting with acute foot pain. Two responded with conservative management whilst the third ultimately required surgery. All athletes were eventually able to return to play.

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“…These scenarios are typically managed with 4 weeks of non–weight-bearing before partial weight-bearing, and then graduated RTP can begin. 33 46…”

Section: Lower Extremitymentioning

confidence: 99%

Osseous Stress Injuries: Treatment Algorithms and Return to Play

Sax

2024

Semin Musculoskelet Radiol

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Osseous stress injuries are common in athletes. Specifically, lower extremity injuries are prevalent in running athletes and upper extremity injuries are prevalent in throwing athletes. Such injuries are suspected when there is focal bone tenderness and increased pain with the inciting activity. In elite athletes, osseous stress injuries are a relatively common culprit in lost play time. Thus rapid diagnosis and treatment is imperative to expedite return to play (RTP). The radiologist's role in these cases is not only for diagnosis, but also to grade the injury, which has implications in determining a treatment regimen. The high sensitivity and specificity of magnetic resonance imaging is thus the preferred imaging modality. This article discusses common osseous stress injuries, the imaging findings, and how different treatment regimens affect RTP.

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Stress Fracture of the Second Metatarsal and Sprain of Lisfranc Joint in a Pre-Professional Ballet Dancer

Cited by 8 publications

References 19 publications

Treatment of paediatric Lisfranc injuries: A systematic review and introduction of a novel treatment algorithm

Treatment of paediatric Lisfranc injuries: A systematic review and introduction of a novel treatment algorithm

Lisfranc Sprain with Second Metatarsal Base Adaptive Stress Response in High-Level Athletes: Case Series and Novel Perspective on a Distinct Entity of Chronic Low-Energy Lisfranc Injury

Osseous Stress Injuries: Treatment Algorithms and Return to Play

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