ARTICLE –
abstractModern
principles of treatment in Lisfranc midfoot dislocations Razvan Bandac Grigore T. Popa University of Medicine and Pharmacy, Iasi, Romania
Abstract
The
Lisfranc midfoot dislocations are uncommon, and the results of the
treatment are often unsatisfactory. The open reduction and internal
fixation of the tarso-metatarsal injuries by various technics like:
Kirschner wiring transfixiation , screwing or combinations of these
methods, are the recommended choice of treatment. The aim of the
present study is to review the functional outcomes of 31 patients with
dislocations and fracture - dislocations of the Lisfranc joint over a
10-year period, treated by different surgical methods. The average
follow-up period was 44 (range 12 – 108) months. Results. The
average American Orthopaedic Foot and Ankle Society (AOFAS) for midfoot
score, used for results interpretation, was 72 (range 52 – 92);
the highest scores were obtained by patients with screwing technics of
internal fixation. Fourteen patients (45%) developed posttraumatic
arthritis of the tarso-metatarsal joints. The major causes were an
imperfect and nonanatomic reduction, and an instable internal fixation,
especially in patients with only Kirschner wiring fixation as single
technique used. Conclusions. On the basis of our study, the
principles of treatment of the Lisfranc tarso-metatarsal fracture-
dislocations are: anatomical open reduction and stable internal
fixation, using transfix screw fixation or a combination of wiring and
screwing techniques.
Key
words:midfoot dislocations, Lisfranc joint, open reduction, internal fixation
Full
article:
Modern principles of treatment in Lisfranc midfoot dislocations
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