Journal of Musculoskeletal Trauma

Comparison of Surgical Outcomes for Lisfranc Joint Injuries: Dorsal Bridge Plating versus Transarticular Screw versus Combination: Ba Rom Kim, Jun Young Lee, Sung Hun Yang, Seung Hyun Lee; J Korean Fract Soc 2023;36(1):17-24. Published online January 31, 2023; DOI: https://doi.org/10.12671/jkfs.2023.36.1.17

Abstract PDF: Purpose
In Lisfranc joint injury, the traditional treatment has been open reduction and internal fixation with a transarticular screw. Despite this, additional complications, such as damage to the articular surface and breakage of the screw, have been reported. Therefore, this study compared the clinical and radiological outcomes of dorsal bridge plating with those of transarticular screws and combination treatment in Lisfranc joint injury.
Materials and Methods
Among the 43 patients who underwent surgical treatment due to Lisfranc joint injury from June 2015 to March 2021, 40 cases followed for more than six months after surgery were analyzed, excluding three patients: one lost to follow-up, one had to amputate, and one expired. The radiological parameters were measured using the Wilppula classification in the last follow-up. The clinical outcomes were evaluated using the American Orthopaedic Foot and Ankle Society (AOFAS) midfoot score.
Results
The AOFAS midfoot score, according to the surgical method, was significantly higher in the dorsal bridge plating (p=0.003). The radiological outcomes showed significantly better anatomical reduction when dorsal bridge plating was used (p=0.040). According to the Wilppula classification, the AOFAS midfoot score improved as the quality of anatomical reduction improved (p=0.018). Finally, the AOFAS midfoot score decreased as the number of column fixations increased (p=0.002). There were two complications: screw breakage in dorsal bridge plating and superficial skin necrosis in the combination treatment. Skin defects caused by necrosis improved after negative pressure wound therapy and split-thickness skin graft.
Conclusion
In treating Lisfranc joint injuries, open reduction and internal fixation by dorsal bridge plating can be an appropriate treatment option. Nevertheless, studies, such as long-term follow-up research, on complications, such as osteoarthritis, will be needed.

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Lisfranc Joint Injury: Bi O Jeong, Jungtae Ahn; J Korean Fract Soc 2022;35(2):83-89. Published online April 30, 2022; DOI: https://doi.org/10.12671/jkfs.2022.35.2.83

Abstract PDF: The Lisfranc joint complex is composed of complex bony structures, ligaments, and soft tissues and has a systematic interrelationship. Sufficient radiologic modalities should be considered for an accurate initial diagnosis. Based on an accurate understanding of normal anatomy and restoration of anatomical relationships, the diagnosis should be obtained, and more discussion is needed on detailed treatment strategies.

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Lisfranc Joint Injuries: Diagnosis and Treatment: Hyun Seok Yim, Sung Ha Hong, Ki Sun Sung; J Korean Fract Soc 2016;29(4):283-293. Published online October 31, 2016; DOI: https://doi.org/10.12671/jkfs.2016.29.4.283

Injuries to the Lisfranc joint are relatively rare, but they are often misdiagnosed or inadequately treated, resulting in poor long-term outcomes. Understanding of anatomical structure and injury mechanism, careful clinical and radiographic evaluations are needed to recognize and treat Lisfranc joint injuries. In this article, we review the anatomy, biomechanics, injury mechanisms, injury classification, clinical presentation, radiographic evaluation, treatment, outcome, and complications of Lisfranc joint injuries.

Citations

Citations to this article as recorded by

Lisfranc Sports Injuries: What Do We Know So Far?
Godsfavour C Maduka, Divinegrace C Maduka, Naeem Yusuf
Cureus.2023;[Epub] CrossRef
Effects of Acupuncture Treatment and Taping Therapy After Lisfranc Joint Injuries: A Case Report
Shin-Ae Kim, Su-Woo Kang, Eun-Ji Lee, Min-Kyung Kwak, Hui-Gyeong Jeong, Jae-Uk Sul
Journal of Acupuncture Research.2017; 34(4): 197. CrossRef

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Fracture & Dislocation of Tarso-metatarsal Joint: Eung Shick Kang, Ho Jung Kang, Ick Hwan Yang, Dong Wha Lee; J Korean Soc Fract 1992;5(2):212-218. Published online November 30, 1992; DOI: https://doi.org/10.12671/jksf.1992.5.2.212

Abstract PDF: The fracture and dislocation of tarso-metatarsal joint is rare injury, but if it occurs, as-sociated soft tissue injury is so severe according to its cause of injury. We reviewed 19 patients of fracture and dislocation of tarso-metatarsal joint who were treated in patient service, during the perlod, from April, 1981 to March, 1991 at our hospital. The results were as follows; 1. Fifteen patients (75%) among the 19 patients were injured due to traffic accident and the associated injury was so severe. 2. Nine cases were treated with percutaneous pinning, closed redoclion with cast immobilization in 2 cases and open reduction with multiple pinning in 8 cases. Three cases needed free vasculariaed flap for its extensive soft tissue injury and, one case was taken below knee amputation for its associatrd severe injury. 3. Anatomical reduction was achieved in 15 cases and iss results were as follows: good in 4 cases. fair in 10 cases and poor in one case Anatomical reduction was not achieved in 3 cases and the results were as follows : fair in one case and poor in 2 cases. 4. Eight cases which were treated with open reduction with multiple pinning had the results as follows: good in one. fair in 6 cases and the remaining one case had taken below knee amputation Seven cases which were treated with closed reductlon and cast immobiliza- cases and poor in 3 cases. 5. The patients who were achieved anatomical reduction had better results than who were not achieved anatomical reduction, Buy the results of all patients were not so satisractory. That is because of the point that the Lisfranc joint injury had associated with severe soft tissue injuries. We concluded that early and active intervention and anatomical reduction should be achieved for the better results.

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