TITLE

Treatment of Primarily Ligamentous Lisfranc Joint Injuries: Primary Arthrodesis Compared with Open Reduction and Internal Fixation

AUTHOR(S)
Coetzee, J. Chris; Ly, Thuan V.
PUB. DATE
March 2007
SOURCE
Journal of Bone & Joint Surgery, American Volume;Mar2007 Supplement, Vol. 89-A, p122
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
BACKGROUND: Open reduction and internal fixation is currently the accepted treatment for displaced Lisfranc joint injuries. However, even with anatomic reduction and stable internal fixation, treatment of these injuries does not have uniformly excellent outcomes. The objective of this study was to compare primary arthrodesis with open reduction and internal fixation for the treatment of primarily ligamentous Lisfranc joint injuries. METHODS: Forty-one patients with an isolated acute or subacute primarily ligamentous Lisfranc joint injury were enrolled in a prospective, randomized clinical trial comparing primary arthrodesis with traditional open reduction and internal fixation. The patients were followed for an average of 42.5 months. Evaluation was performed with clinical examination, radiography, the American Orthopaedic Foot and Ankle Society (AOFAS) Midfoot Scale, a visual analog pain scale, and a clinical questionnaire. RESULTS: Twenty patients were treated with open reduction and screw fixation, and twenty-one patients were treated with primary arthrodesis of the medial two or three rays. Anatomic initial reduction was obtained in eighteen of the twenty patients in the open-reductio group and twenty of the twenty-one in the arthrodesis group. At two years postoperatively, the mean AOFAS Midfoot score was 68.6 points in the open-reduction group and 88 points in the arthrodesis group (p < 0.005). Five patients in the open-reduction group had persistent pain with the development of deformity or osteoarthrosis, and they were eventually treated with arthrodesis. The patients who had been treated with a primary arthrodesis estimated that their postoperative level of activities was 92% of their preinjury level, whereas the open-reduction group estimated that their postoperative level was only 65% of their preoperative level (p < 0.005). CONCLUSIONS: A primary stable arthrodesis of the medial two or three rays appears to have a better short and medium-term outcome than open reduction and internal fixation of ligamentous Lisfranc joint injuries.
ACCESSION #
24308706

 

Related Articles

  • TREATMENT OF PRIMARILY LIGAMENTOUS LISFRANC JOINT INJURIES: PRIMARY ARTHRODESIS COMPARED WITH OPEN REDUCTION AND INTERNAL FIXATION. Ly, Thuan V.; Coetzee, J. Chris // Journal of Bone & Joint Surgery, American Volume;Mar2006, Vol. 88-A Issue 3, p514 

    Background: Open reduction and internal fixation is currently the accepted treatment for displaced Lisfranc joint injuries. However, even with anatomic reduction and stable internal fixation, treatment of these injuries does not have uniformly excellent outcomes. The objective of this study was...

  • Lisfranc fracture dislocation in a child. Yap, L.; Yates, E.; Ul-Haque, M.; Sarin, R. // European Journal of Orthopaedic Surgery & Traumatology;Aug2009, Vol. 19 Issue 6, p437 

    A case of Lisfranc fracture dislocation complicated by compartment syndrome is reported in a 9-year-old boy who fell from a 5 ft high wall which subsequently collapsed onto him crushing his lower limbs. The patient also sustained an undisplaced, open fracture of the contralateral tibia. The...

  • The injuries to the fourth and fifth tarsometatarsal joints: A review of the surgical management by internal fixation, arthrodesis and arthroplasty. Xiao Yu; Qing-jiang Pang; Guang-rong Yu // Pakistan Journal of Medical Sciences;Apr2013, Vol. 29 Issue 2, p687 

    The surgical management to the injuries of the fourth and fifth tarsometatarsal (TMT) joints is controversial. We briefly review the anatomical characteristics to the injuries, the diagnosis, as well as the individualized treatment of the injuries of the fourth and fifth TMT joints by open...

  • Lisfranc injuries. Loveday, David; Robinson, Andrew // British Journal of Hospital Medicine (17508460);Jul2008, Vol. 69 Issue 7, p399 

    The article discusses the causes and treatments of lisfranc injuries. The authors stated that to minimize the long-term consequence, an early diagnosis and urgent orthopaedic referral is required. They added that the injuries may be the result of direct or indirect trauma and in most cases...

  • Outcome after anatomic reduction and transfixation with Kirschner wires of Lisfranc joint injuries. Korres, Dimitrios S.; Psicharis, Ioannis P.; Gandaifis, Nikolaos; Papadopoulos, Elias C.; Zoubos, Aristides B.; Nikolopoulos, Konstantinos // European Journal of Orthopaedic Surgery & Traumatology;Jun2003, Vol. 13 Issue 2, p85 

    Injuries to the tarsometatarsal (Lisfranc) joint are uncommon, and the results of treatment are often unsatisfactory. Open reduction and internal fixation has been recommended as the treatment of choice for most unstable injuries. In the present study, we reviewed 16 patients who underwent...

  • Functional outcomes for unstable distal fractures treated with open reduction and internal fixation or closed reduction and percutaneous fixation. A prospective randomized trial.  // Advances in Orthopaedics;Mar2010, Vol. 2 Issue 1, p31 

    The article focuses on the result of a study regarding the functional outcomes for unstable distal fractures that were treated with open reduction and internal fixation, or closed reduction and percutaneous fixation. Through a randomized controlled trial, it compared closed...

  • Management of a Stage III Lisfranc Ligament Injury in a Collegiate Football Player. Hummel, Chris H.; Lazenby, Todd W.; Geisler, Paul R. // Athletic Training & Sports Health Care: The Journal for the Prac;Mar/Apr2011, Vol. 3 Issue 2, p95 

    The diagnosis and management of the Lisfranc joint injury is a complicated and sometimes frustrating endeavor. Some consensus exists on the diagnosis of Lisfranc injuries; however, the proper management of these subtle injuries is still debated and poorly reported. This case review highlights a...

  • Lisfranc fracture. Summers, Anthony // Emergency Nurse;Nov2007, Vol. 15 Issue 7, p20 

    This article offers information about Lisfranc fracture. Lisfranc fracture is a rare dislocation that accounts for less than one percent of all orthopedic trauma, or one case in 55,000 ED patients. Due to the rarity of Lisfranc fractures, up to 20 percent are missed on initial presentation. The...

  • Lisfranc joint injuries. Davis, Edward T. // Trauma;Oct2006, Vol. 8 Issue 4, p225 

    Injuries to the tarsometatarsal (Lisfranc's) joint can be difficult injuries to diagnose. Some authors report that up to 20% of injuries are wrongly diagnosed. There remains controversy as to adequacy of closed reduction and fixation compared to open reduction with anatomical reduction and...

Share

Read the Article

Courtesy of VIRGINIA BEACH PUBLIC LIBRARY AND SYSTEM

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics