Aims. This systematic review and meta-analysis was conducted to compare open reduction and internal fixation (ORIF) with primary arthrodesis (PA) in the treatment of
The results of treatment of
Introduction. Lisfranc joint injuries are increasingly recognised in elite soccer and rugby players. Currently no evidence-based guidelines exist on timeframes for return to training and competition following surgical treatment. This study aimed to see whether return to full competition following surgery for
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
In this study we decided to observe the incidence of osteoarthritis following ORIF of Lisfranc joint injury. We also intended to point out the influence of different factors such as late diagnosis of the fracture, co-fractures, and open or close fractures on the incidence of osteoarthritis. Patients with a dislocation more than 2 millimeters in simple AP, lateral and oblique radiograms of the foot who went through ORIF were included. Patients were classified according to: Anatomic or non-anatomic reduction, open or close fractures, presence of other fractures and early or late diagnosis (up to 6 weeks). The incidence of osteoarthritis was then compared in these groups.Introduction
Methods
Introduction. Lisfranc joint injuries account for only 0.2% of all fractures but early diagnosis improves the chances of a better outcom]. Radiographic signs, such as diastasis (>2mm) of the 1–2 interspace, are subtle and. often missed, leading to a poorer outcome. We present a new radiographic sign, less likely to result in missed diagnoses. Null nypothesis: The intermetarsal angle remains unchanged in
There is debate whether a home run screw (medial cuneiform to 2nd metatarsal base) combined with k-wire fixation of 4th & 5th rays is sufficient to stabilise Lisfrance injuries or if fixation of the 3rd ray is also required. Unlike the 2nd, 4th and 5th TMTJ, stabilisation of the 3rd requires either intra-articular screw or a cross joint plate which both risk causing chondrolysis and/or OA. Using 8 Theil embalmed specimens, measurements of TMTJ dorsal displacement at each ray (1st to 5th) and 1st – 2nd metatarsal gaping were made during simulated weight bearing with sequential ligamentous injury and stabilisation to determine the contribution of anatomical structures and fixation to stability. At baseline mean dorsal TMTJ displacement of the intact specimens during simulated weight bearing (mm) was: 1st: 0.14, 2nd: 0.1, 3rd:0, 4th: 0, 5th: 0.14. The 1st-2nd IM Gap was 0mm. After transection of the Lisfranc ligament only, there was 1st-2nd intermetatarsal gaping (mean 4.5mm), but no increased dorsal displacement. After additional transection of all the TMTJ ligaments dorsal displacement increased at all joints (1st: 4.5, 2nd: 5.1, 3rd: 3.6, 4th: 2, 5th: 1.3). Stabilisation with the home run screw and 4th and 5th ray k-wires virtually eliminated all displacement. Further transection of the 3rd/4th inter-metatarsal ligaments increased mean dorsal displacement of the 3rd ray to 2.5mm. K-wire fixation of the 3rd ray completely eliminated dorsal displacement. The results suggest that stabilising the 2nd and 4/5th TMTJs will stabilise the 3rd if the inter-metatarsal ligaments are intact. Thus 3rd TMTJ stability should be checked after stabilising the 2nd and 4/5th. Provided the intermetatarsal ligaments (3rd-4th) are intact the 3rd ray does not need to be stabilised routinely.
Injuries to the foot in athletes are often subtle
and can lead to a substantial loss of function if not diagnosed
and treated appropriately. For these injuries in general, even after
a diagnosis is made, treatment options are controversial and become
even more so in high level athletes where limiting the time away
from training and competition is a significant consideration. In this review, we cover some of the common and important sporting
injuries affecting the foot including updates on their management
and outcomes. Cite this article:
Background. Undisplaced Lisfranc-type injuries are subtle but potentially unstable fracture-dislocations with little known about the natural history. These injuries are often initially managed conservatively due to lack of initial displacement and uncertainty regarding subsequent instability at the tarsometatarsal joints (TMTJ). The aim of this study was to determine the secondary displacement rate and the need for delayed operative intervention in undisplaced
Background. Anatomical reduction of unstable
Background. Lisfranc fracture dislocations are uncommon injuries, which frequently require surgical intervention. Currently, there is varying evidence on the diagnostic utility of plain radiographs (XR) and CT in identifying
The April 2023 Foot & Ankle Roundup. 360. looks at: Outcomes following a two-stage revision total ankle arthroplasty for periprosthetic joint infection; Temporary bridge plate fixation and joint motion after an unstable
Being commonly missed in the clinical practice,
Open reduction and internal fixation (ORIF) with trans-articular screws or dorsal plating is the standard surgical technique for displaced
Introduction:
Introduction: The unique architecture of the tarsometa-tarsal joints gives rise to a complex articulation between the midfoot and forefoot. The
Anatomical variation of Lisfranc mortise has been implicated in the susceptibility of Lisfranc fracture-dislocation. We investigated whether the variations in the dimensions of second metatarsal base makes the joint vulnerable to fracture dislocation. Patients and Methods: 31 normal (group A) and 23 injured (group B) foot x-rays were compared. The average age of patients was 33(range 16–64) years. Routine AP and 45 degree oblique foot x-rays were used to measure second metatarsal parameters such as L (length of second metatarsal) were measured on x-rays in both groups. Additionally D (height of base of second metatarsal in sagittal plane of foot) was measured in CT scans. Statistical analysis was performed to test the viability of the null hypothesis that states that the relationship of second metatarsal length and height at the base does not correlate with increased susceptibility of