FRACTURES AND DISLOCATIONS OF THE LISFRANCA JOINT
https://doi.org/10.51922/1818-426X.2024.3.42
Abstract
The article provides current data on the applied anatomy of the Lisfranc joint, mechanisms of injury, classification, diagnostics and treatment. Lisfranc joint injuries are relatively rare – just 0,2 % of all fractures. They include wide spectrum of injuries: from ligament tears to complex fracture-dislocations with severe concomitant soft-tissue injuries. Up to one third of injuries are missed during initial examination. When properly not diagnosed and not treated early these injuries may lead to severe disability. Initial radiological diagnostics shall include three standard projections: AP, lateral and AP with foot pronation. CT (especially 3D-reconstructions) play important role in the pre-operative planning, and in the diagnostics of the injuries with only mild displacements. During initial treatment it is important to reduce grobe displacements of the forefoot, which may lead to compartmentsyndrome or disorders of the blood supply of the distal part of foot. Closed reduction and wire fixation is appropriate only as initial emergent treatment. The mainstay of the definitive fixation is the open reduction and solid fixation (with screws and/or plates) which enables the restoration of the middle foot stability.
About the Authors
A. A. Sitnik
ГУ «РНПЦ травматологии и ортопедии»
Belarus
Belarus
O. A. Korzun
ГУ «РНПЦ травматологии и ортопедии»
Belarus
Belarus
A. V. Beleckij
Национальная академия наук Беларуси
Belarus
Belarus
M. A. Gerasimenko
ГУ «РНПЦ травматологии и ортопедии»; Национальная академия наук Беларуси
Belarus
Belarus
References
1. Sitnik, A. A. Lechenie otkrytyh perelomov nizhnih konechnostej v sovremennyh usloviyah / A. A. Sitnik, A. V. Beleckij // Med. novosti. – 2011. – № 7. – S. 27–31.
2. Ahluwalia, R. [et al.]. Surgical controversies and current concepts in Lisfranc injuries // British medical bulletin. – 2022. – № 1 (144). – P. 57–75.
3. Bansal, A. [et al.]. Ligamentous Lisfranc Injury: A Biomechanical Comparison of Dorsal Plate Fixation and Transarticular Screws // Journal of orthopaedic trauma. – 2019. – № 7 (33). – P. e270–e275.
4. Coetzee, J. C., Ly T. V Treatment of primarily ligamentous Lisfranc joint injuries: primary arthrodesis compared with open reduction and internal fixation. Surgical technique // The Journal of bone and joint surgery. American volume. – 2007. – Vol. 89, Suppl 2. – P. 122–127.
5. Desmond, E. A., Chou L. B. Current concepts review: Lisfranc injuries // Foot & ankle international. – 2006. – № 8 (27). – P. 653–660.
6. Hatem, S. F. Imaging of lisfranc injury and midfoot sprain // Radiologic clinics of North America. – 2008. – № 6 (46). – P. 1045–60.
7. Henning, J. A. [et al.]. Open reduction internal fixation versus primary arthrodesis for lisfranc injuries: a prospective randomized study // Foot & ankle international. – 2009. – № 10 (30). – P. 913–922.
8. Lau, S., Bozin M., Thillainadesan T. Lisfranc fracture dislocation: a review of a commonly missed injury of the midfoot // Emergency medicine journal: EMJ. – 2017. – № 1 (34). – P. 52–56.
9. Llopis, E. [et al.]. Lisfranc Injury Imaging and Surgical Management // Seminars in musculoskeletal radiology. – 2016. – № 2 (20). – P. 139–153.
10. Mulcahy, H. Lisfranc Injury: Current Concepts // Radiologic clinics of North America. – 2018. – № 6 (56). – P. 859–876.
11. Myerson, M. S. [et al.]. Fracture dislocations of the tarsometatarsal joints: end results correlated with pathology and treatment // Foot & ankle. – 1986. – № 5 (6). – P. 225–242.
12. Myerson, M. S., Cerrato R. A. Current management of tarsometatarsal injuries in the athlete // The Journal of bone and joint surgery. American volume. – 2008. – № 11 (90). – P. 2522–2533.
13. Nunley, J. A., Vertullo C. J. Classification, investigation, and management of midfoot sprains: Lisfranc injuries in the athlete // The American journal of sports medicine. – 2002. – № 6 (30). – P. 871–878.
14. de Palma, L. [et al.]. Anatomy of the Lisfranc joint complex // Foot & ankle international. – 1997. – № 6 (18). – P. 356–364.
15. Panchbhavi, V. K. [et al.]. A minimally disruptive model and three-dimensional evaluation of Lisfranc joint diastasis // The Journal of bone and joint surgery. American volume. – 2008. – № 12 (90). – P. 2707–2713.
16. Siddiqui, N. A. [et al.]. Evaluation of the tarsometatarsal joint using conventional radiography, CT, and MR imaging // Radiographics: a review publication of the Radiological Society of North America, Inc. – 2014. – № 2 (34). – P. 514–531.
17. Stavlas, P. [et al.]. The role of reduction and internal fixation of Lisfranc fracture-dislocations: a systematic review of the literature // International orthopaedics. – 2010. – № 8 (34). – P. 1083–1091.
18. Watson, T. S., Shurnas P. S., Denker J. Treatment of Lisfranc joint injury: current concepts // The Journal of the American Academy of Orthopaedic Surgeons. – 2010. – № 12 (18). – P. 718–728.
19. Weatherford, B. M., Bohay D. R., Anderson J. G. Open Reduction and Internal Fixation Versus Primary Arthrodesis for Lisfranc Injuries // Foot and ankle clinics. – 2017. – № 1 (22). – P. 1–14.
20. Welck, M. J., Zinchenko R., Rudge B. Lisfranc injuries // Injury. – 2015. – № 4 (46). – P. 536–541.
Review
For citations:
Sitnik A.A., Korzun O.A., Beleckij A.V., Gerasimenko M.A. FRACTURES AND DISLOCATIONS OF THE LISFRANCA JOINT. Medical Journal. 2024;(3):42-49. (In Russ.) https://doi.org/10.51922/1818-426X.2024.3.42
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