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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Treatment of the Tarsometatarsal Joint Fracture-Dislocation: Kun Yung Lee, Young Kee Lee, Yong Man Cho, Heung Sik Kang; J Korean Soc Fract 1996;9(3):725-732. Published online July 31, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.3.725

Abstract PDF: Traumatic dislocation and fracture-dislocation of the tarsometatarsal joint rare injuries. These injuries often missed because radiographs of this joint is difficult to be interpreted, so delay to be diagnosed and treated. These injuries often leads to arthritic change with significant residual symptoms and deformities. Tarsometatarsal joint injuries are generally managed by accurate repositioning of the displaced metatarsals and stabilization with instruments(K-wire, screws etc.). The purpose of this study is to review the anatomical, radiological and functional results. The authors analysed the 25 cases with injuries of the tarsometatarsal joint treated of the department of Orthopaedic Surgery, Lee-Rha general hospital from March 1989 to September 1994, which showed the following results. 1. The most common cause of the injury was traffic accident(76%). 2. According to the Hardcastles classification, the injuries were classified as follows:partial incongruity in 16 cases(64%), total incongruity in 6 cases(24%), and divergent congruity in 3 cases(12%). 3. Three cases were treated with closed reduction and case immobilization, thirteen cases were treated with closed reduction and percutaneous K-wire fixation. Nine cases were treated with open reduction and K-wire fixation as follows:reduction failure in 3 cases, entrapment of anterior tibial tendon in 2 cases, severe soft tissue injury in 4 cases. 4. The anatomic reduction and its maintenance were considered as most important factor of prognosis.

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Treatment of Fracture-Dislocation of Tarsometatarsal Joint: Chung Nam Kang, Jong Oh Kim, Sang Hun Ko; J Korean Soc Fract 1996;9(3):715-724. Published online July 31, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.3.715

Abstract PDF: The tarsometatarsal fracture-dislocation are unusual freguency. Lesion in this area are generally the result of a high energy traulna and difficult to recognize on standard radiographs. Twenty-one casei of fracture and dislocation of the tarsometatarsal joint were treated by open or closed reduction from January 1991 to April 1996. We assessed clnical result & treatment result and the following results were obtained. 1. Anatomical reduction is likely to lead nearly normal function & little complications. 2. Due to soft tissue interposition, espicially interposition of tibialis anterior, and marked articular comminution, early closed reduction was failed in 3 cases. If the closed reduction is tossed, then open reduction and internal fixation was performed. 3. In cases of nearly anatomical reduction, good prognosis was obtained. 4. Accurate accessment of AP & oblique & lateral projection of radiographs were very adventa geous & important. 5. Open anatomical reduction was superior to closed reduction & percataneous pining & cast immobilization alone.

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Unusual Isolated lateroplantar Dislocation of the First Tarsometatarsal Joint: A case Report: Joo Hong Lee, Jae Hoon Lee, Hak Ji Kim, Kyung Jin Song, Byung Yun Hwang; J Korean Soc Fract 1996;9(2):349-353. Published online April 30, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.2.349

Abstract PDF: Dislocation and fracture-dislocation fo the Tarsometatarsal joint were rare injuries, but an increase of motor vehicle accidents, industrial and athletic injuries seems to be responsible for an incresing incidence of these injuries. Because of the basic inherent stabilith of the bony architecture and the structures on the sole of the foot including the plantar fascia, the intrinsic foot muscles, peroneus, tibialis posterior tendon and the stronger plantar pligaments most dislocations occur in dorsal and lateral direction. We report a case of 32 year-old male patient who had an isolated fracture and disloction of the first Tarsometatarsal joint with laterai and plantarward displacement. This developed by in-car accident and which did not fit to any proposed classification systems. The diagnosis was delayed because of the combined injuries, but with open reduction and internal fixation with 2 smooth K-wires, satisfactory results could at 12 moonths follow-up study.

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Injuries of the Tarsometatarsal Joint: Chong Il Yoo, Jeung Tak Suh, Kuen Tak Suh, Yong Jin Kim, Hui Taeg Kim, Kie Bong Wang; J Korean Soc Fract 1992;5(2):219-226. Published online November 30, 1992; DOI: https://doi.org/10.12671/jksf.1992.5.2.219

Abstract PDF: Because of the anatomical configuration of the tarsornetatarsal joints with their strong ligmanet connections, the injries in this regicon are rare. But the injury is associated with a high potential for chronic disability.Authors reviewed and clinically analysed 18 cases of tarsometatarsal joint injuries which were followed more than one year at the orthopedic department of Pusan National University durging the period from January 1986 to December 1990. The results were as follows ; 1. The incidence was higher in male and young active age group. 2. The most common cause of the injury was traffic accident (50.0%). 3. Tarsal and metatarsal fractures were commonly combined (61.1%) 4. The most frequent injury type by Hardcastles classification was total inconjgrulty type (55.5%). 5. Overall result estimated by Hardcastles criteria was good in 5 cases (27.8%), fair in 8 cases (44.4%), and poor in 5 cases (27.8%). 6. The causes of poor resulted cases were severe crushing injury, inadequate anatomical reduction, delayed treatment due to combind injury and loss of medial longitudinal arch. 7. Late complications such as traumatir arthrltis, paln and foot deformity were seen more than half of the cases.

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Treatment of Fracture and/or Dislocation of the Tarsometatarsal Joint, using AO Screws: Two cases Report: Yung Khee Chung, Jung Han Yoo, Baek Yong Song; J Korean Soc Fract 1989;2(1):107-112. Published online June 30, 1989; DOI: https://doi.org/10.12671/jksf.1989.2.1.107

Abstract PDF: Fracture and/or dislocations of the tarsometatarsal joint are rare yet carry such a high potential for chronic disability. These injuries have been frequently followed by poor end results by the failure of timely diagnosis, incomplete reduction, or redislocation after inadequate treatment. These disappointing results have made us to give an aggressive approach for thses injuries consisting of open reduction and temporary rigid internal fixation using AO screws.

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