TITLE

Screw Fixation Compared with Suture-Button Fixation of Isolated Lisfranc Ligament Injuries

AUTHOR(S)
Panchbhavi, Vinod K.; Vallurupalli, Santaram; Jinping Yang; Andersen, Clark R.
PUB. DATE
May 2009
SOURCE
Journal of Bone & Joint Surgery, American Volume;May2009, Vol. 91-A Issue 5, p1143
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Background: A cannulated screw is currently used to reduce and stabilize diastasis at the Lisfranc joint. The screw requires removal and may break in situ. A suture button does not have these disadvantages, but it is not known if it can provide stability similar to that provided by a cannulated screw or an intact Lisfranc ligament. The objective of the present study was to compare the stability provided by a suture button with that provided by a screw when used to stabilize the diastasis associated with Lisfranc ligament injury. Methods: Fourteen fresh-frozen, paired cadaveric feet were dissected to expose the dorsal region. A registration marker triad consisting of three screws was fixed to the first cuneiform and the second metatarsal. A digitizer was utilized to record the three-dimensional positions of the registration markers and their displacement in test conditions before and after cutting of the Lisfranc ligament and after stabilization of the joint with either a suture button or a cannulated screw. The first and second cuneiforms and their metatarsals were removed, and the ligament attachment sites were digitized. Displacement at the Lisfranc ligament and the three-dimensional positions of the bones were determined. Results: Loading with the Lisfranc ligament cut resulted in displacement that was significantly different from that after screw fixation (p = 0.0001), with a difference between means of 1.2 mm. Likewise, loading with the Lisfranc ligament cut resulted in a displacement that was significantly different from that after suture-button fixation (p = 0.0008), with a difference between means of 1.00 mm. No significant difference in displacement was found between specimens fixed with the suture button and those fixed with the screw. Conclusions: Suture-button fixation can provide stability similar to that provided by screw fixation in cadaver specimens after isolated transection of the Lisfranc ligament. Clinical Relevance: Fixation with a suture button may be an acceptable alternative to screw fixation in the treatment of isolated Lisfranc ligament injuries, avoiding subsequent surgery to remove the hardware prior to weight-bearing.
ACCESSION #
39658504

 

Related Articles

  • Open Reduction and Internal Fixation of Capitellar Fractures with Headless Screws. Ruchelsman, David E.; Tejwani, Nirmal C.; Kwon, Young W.; Egol, Kenneth A. // Journal of Bone & Joint Surgery, American Volume;Mar2009 Supplement, Vol. 91-A, p38 

    BACKGROUND: The outcome of operatively treated capitellar fractures has not been reported frequently. The purpose of the present study was to evaluate the clinical, radiographic, and functional outcomes following open reduction and internal fixation of capitellar fractures that were treated with...

  • A Nonlocking End Screw Can Decrease Fracture Risk Caused by Locked Plating in the Osteoporotic Diaphysis. Bottlang, Michael; Doornink, Josef; Byrd, Gregory D.; Fitzpatrick, Daniel C.; Madey, Steven M. // Journal of Bone & Joint Surgery, American Volume;Mar2009, Vol. 91-A Issue 3, p620 

    Background: Locking plates transmit load through fixed-angle locking screws instead of relying on plate-to-bone compression. Therefore, locking screws may induce higher stress at the screw-bone interface than that seen with conventional nonlocked plating. This study investigated whether locked...

  • Realignment and Extended Fusion with Use of a Medial Column Screw for Midfoot Deformities Secondary to Diabetic Neuropathy. Assal, Mathieu; Stern, Richard // Journal of Bone & Joint Surgery, American Volume;Apr2009, Vol. 91-A Issue 4, p812 

    Background: The failure of nonsurgical treatment of patients with midfoot and hindfoot deformity secondary to diabetic Charcot arthropathy may lead to a rocker-bottom foot deformity with recurrent or persistent plantar ulceration. We report our experience with realignment and extended fusion...

  • Distal Tibial Reconstruction with Use of a Circular External Fixator and an Intramedullary Nail. Eralp, Levent; Kocaoglu, Mehmet // Journal of Bone & Joint Surgery, American Volume;Oct2008 Supplement 2, Vol. 90-A, p181 

    BACKGROUND: Distal tibial reconstruction with use of an external fixator when there is bone loss, limb-length discrepancy, and/or ankle instability is associated with many problems. The technique of limb-lengthening, ankle arthrodesis, and segmental transfer over an intramedullary nail has been...

  • Femoral Nerve Block for Diaphyseal and Distal Femoral Fractures in the Emergency Department. Mutty, Christopher E.; Jensen, Erik J.; Manka Jr., Michael A.; Anders, Mark J.; Bone, Lawrence B. // Journal of Bone & Joint Surgery, American Volume;Oct2008 Supplement 2, Vol. 90-A, p218 

    BACKGROUND: Diaphyseal and distal femoral fractures are painful injuries that are frequently seen in patients requiring a trauma work-up in the hospital emergency department prior to definitive management. The purpose of this study was to determine whether a femoral nerve block administered in...

  • Thoracolumbar Burst Fractures Treated with Posterior Decompression and Pedicle Screw Instrumentation Supplemented with Balloon-Assisted Vertebroplasty and Calcium Phosphate Reconstruction. Marco, Rex A. W.; Kushwaha, Vivek P. // Journal of Bone & Joint Surgery, American Volume;Jan2009, Vol. 91-A Issue 1, p20 

    Background: The treatment of unstable thoracolumbar burst fractures with short-segment posterior spinal instrumentation without anterior column reconstruction is associated with a high rate of screw breakage and progressive loss of reduction. The purpose of the present study was to evaluate the...

  • Operative Management of Distal Radial Fractures with 2.4-Millimeter Locking Plates: A Multicenter Prospective Case Series. Jupiter, Jesse B.; Marent-Huber, M. // Journal of Bone & Joint Surgery, American Volume;Jan2009, Vol. 91-A Issue 1, p55 

    Background: In the past decade, there has been a trend toward open reduction and internal fixation of unstable distal radial fractures. There are now more than thirty different implant designs specific for the fixation of distal radial fractures. A multicenter prospective study of a case series...

  • Fractures of the Capitellum and Trochlea. Guitton, Thierry G.; Doornberg, Job N.; Raaymakers, Ernst L. F. B.; Ring, David; Kloen, Peter // Journal of Bone & Joint Surgery, American Volume;Feb2009, Vol. 91-A Issue 2, p390 

    Background: Recent work has established that apparently isolated fractures of the capitellum are often more complex and involve the lateral epicondyle, trochlea, and posterior aspect of the distal part of the humerus. We assessed the experience with operative stabilization of fractures of the...

  • Fractures of the Lesser Tuberosity of the Humerus. Robinson, C. Michael; Teoh, Kar H.; Baker, Alex; Bell, Lawrence // Journal of Bone & Joint Surgery, American Volume;Mar2009, Vol. 91-A Issue 3, p512 

    Background: Fractures of the lesser tuberosity are rare injuries, and little is known of their epidemiology. Operative treatment is generally recommended for displaced fractures; however, the outcome of this method of treatment has not previously been studied. The aims of our study were to...

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