Abstract
Background
Anatomical reduction and stable internal fixation has been recommended as the standard treatment for fracture dislocations of the tarsometatarsal (Lisfranc) joint. Many methods of fixation have been utilised including K-wires and screw fixation, the latter being the preferred method as it provides a stronger more stable construct. However, the screws require removal after the injury has healed.
We present a different method and technique of stabilisation utilising memory staples. The technique is extra-articular and avoids breaching the TMTJ joint surface, is simple and avoids the necessity of removal of hardware.
Methods
11 patients with isolated ligamentous Lisfranc injuries were treated with memory staple fixation over the past 4 years at our centre. Patients' outcome was assessed with use of the Foot & Ankle Disability Index (FADI) Score, the American Foot & Ankle Score, radiographic and clinical follow-up at an average time of 2 years post surgery.
Results
The average FADI score was 86.4 (on a scale of 100 points, with 100 points indicating an excellent outcome). The average American Foot & Ankle score was 90 out of a 100. All patients demonstrated stable long term reduction of the TMT joints and none have required subsequent fusion. In all but 1 patient, there had been fatigue failure of the memory staples making hardware removal unnecessary.
Conclusion
Internal fixation of Lisfranc joint fracture-dislocation with memory staples is an effective fixation method with results comparable to conventional screw fixation with the added benefit of alleviating the need for further surgery to remove the metal work.
