The Treatment of Lisfranc Injuries: Review of Current Literature

Mulier, T; Haan, Julien de; Vriesendorp, Pieter A.; Reynders, P

doi:10.1007/s00068-010-1034-5

Cited by 17 publications

(6 citation statements)

References 28 publications

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“…The medial 3 TMT joints are considered nonessential joints, and fusion of these joints is well tolerated by patients. 8 , 13 , 18 , 19 , 22 The first tarsometatarsal joint is more mobile than the central TMT joints, and preserving this joint might be beneficial. 21 As there is almost no motion in the second and third TMT joints and these joints have a tendency to develop painful osteoarthritis, these joints were fused in the present study.…”

Section: Discussionmentioning

confidence: 99%

Temporary Bridge Plating vs Primary Arthrodesis of the First Tarsometatarsal Joint in Lisfranc Injuries: Randomized Controlled Trial

et al. 2020

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Background: Unstable Lisfranc injuries are best treated with anatomic reduction and stable fixation. There are controversies regarding which type of stabilization is best. In the present study, we compared primary arthrodesis of the first tarsometatarsal (TMT) joint to temporary bridge plating in unstable Lisfranc injuries. Methods: Forty-eight patients with Lisfranc injuries were included and followed for 2 years. Twenty-four patients were randomized to primary arthrodesis (PA) of the medial 3 TMT joints, whereas 24 patients were randomized to temporary bridge plate (BP) over the first TMT joint and primary arthrodesis of the second and third TMT joints. The main outcome parameter was the American Orthopaedic Foot & Ankle Society (AOFAS) midfoot scale and the secondary outcome parameters were the 36-Item Short Form Health Survey (SF-36) and visual analog scale for pain (VAS pain). Computed tomography (CT) scans pre- and postoperatively were obtained. Radiographs were obtained at follow-ups. Pedobarographic examination was performed at the 2-year follow-up. Twenty-two of 24 patients in the PA and 23/24 in the BP group completed the 2-year follow-up. Results: The mean AOFAS midfoot score 2 years postoperatively was 89 (SD 9) in the PA group and 85 (SD 15) in the BP group ( P = .32). There were no significant differences between the groups with regard to SF-36 or VAS pain scores. The alignment of the first metatarsal was better in the BP group than in the PA group measured by the anteroposterior Meary angle ( P = .04). The PA group had a reduced peak pressure under the fifth metatarsal ( P = .047). In the BP group, 11/24 patients had radiologic signs of osteoarthritis in the first TMT joint. Conclusion: Both treatment groups had good outcome scores. The first metatarsal was better aligned in the BP group; however, there was a high incidence of radiographic osteoarthritis in this group. Level of Evidence: Therapeutic level I, prospective randomized controlled study.

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Section: Discussionmentioning

confidence: 99%

Temporary Bridge Plating vs Primary Arthrodesis of the First Tarsometatarsal Joint in Lisfranc Injuries: Randomized Controlled Trial

et al. 2020

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“…Pain with manipulation of the tarsometatarsal joint, plantar ecchymoses, and instability on stress radiographs are additional clinical tools that facilitate making the diagnosis. 15,17,26…”

Section: Indicationsmentioning

confidence: 99%

“…Posttraumatic arthritis and debilitating pain are also potential sequelae in patients with Lisfranc injuries. 15…”

Section: Complicationsmentioning

confidence: 99%

“…Instability is often associated with a full-thickness ligament tear and suggested by an avulsion fracture at the base of the second metatarsal. 15,17,26 This can be seen as a characteristic "fleck" sign on plain radiographs. Pain with manipulation of the tarsometatarsal joint, plantar ecchymoses, and instability on stress radiographs are additional clinical tools that facilitate making the diagnosis.…”

Section: Indicationsmentioning

confidence: 99%

“…Pain with manipulation of the tarsometatarsal joint, plantar ecchymoses, and instability on stress radiographs are additional clinical tools that facilitate making the diagnosis. 15,17,26 The InternalBrace is indicated in patients with acute or chronic ligamentous injuries to the Lisfranc joint. Intercuneiform instability can also be addressed following stabilization of the Lisfranc joint by utilizing the remaining free suture ends of the InternalBrace, as will be described.…”

Section: Indicationsmentioning

confidence: 99%

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Flexible Fixation Technique for Lisfranc Injuries

et al. 2019

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Injuries to the Lisfranc complex range from purely ligamentous disruptions to fracture-dislocations of the tarsometatarsal joint. Treatment options include closed/open reduction with percutaneous pinning, open reduction and internal fixation (ORIF), and primary arthrodesis. We present a ligament reinforcement technique utilizing a flexible fixation device for the treatment of ligamentous Lisfranc injuries. Level of Evidence: Level V, expert opinion.

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