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We reviewed cases with Lisfranc injuries who presented to our center in order to study the adequacy of the treatment method and their final functional outcome.
This is a retrospective review of 34 cases diagnosed with Lisfranc injuries treated at our center from 2000 to 2006. This review is aimed to determine the demography and functional outcome of all patients with Lisfranc injury treated during this period.
The injury was classified based on the "Hardcastle and Associates Classification". In our review, we found that the commonest Lisfranc injury was type B2 (41%). These injuries are mostly fixed with K-wires (76.5%). All patients assessed with Bristol Foot Score (BFS) had a good score in all categories, with a total score ranging from 16 to 25.
We concluded that all Lisfranc injuries, whether treated with closed or open fixation methods, demonstrated a good long-term functional outcome.
Lisfranc dislocations and fracture dislocations are the most common severe injuries of the foot.
To assess the functional outcome of patients with Lisfranc dislocations of the midfoot by applying the latest methods of diagnosis and treatment.
MATERIAL AND METHODS:
The study reviewed 31 patients with dislocations and fracture- dislocations of the Lisfranc joint over a 10 years period. The average follow-up period was 44 months (range 12-108). Injuries were classified according to Myerson scale.
The outcomes were evaluated using the Baltimore Painful Foot score (PFS) and American Orthopaedic Foot and Ankle Society (AOFAS) mid-foot scoring scale. 10 patients had an excellent outcome on the PFS scale, 8 were classified as good, 13 fair and poor. The average AOFAS score for the midfoot. used for results interpretation was 72 (range 52-92).
Of all methods of surgical treatment used, the highest scores were obtained by internal fixation with screws. Eight patients (25.8 %) developed posttraumatic arthritis of the tarsometatarsal joints.
Long-term results of the treatment of Lisfranc fracture dislocation
García-Renedo RJ, Carranza-Bencano A, Busta-Vallina B, Ortiz-Segura J, Plaza-García S, Gómez-del Alamo G. Acta Ortop Mex. 2012 Jul-Aug;26(4):235-44.
We conducted an ambispective cohort study of 83 patients with a diagnosis of Lisfranc fracture dislocation from 1993 to 2008. The lesions were classified into two groups: pure dislocations and fracture dislocations of the Lisfranc joint using the Hardcastle-Reschamer classification. The results included the following data: sociodemographic and epidemiologic variables, lesion-related variables, clinical parameters, and the following clinical and functional assessment scales: Baltimore Painful Foot Score, Creighton-Nebraska Health Foundation, American Orthopaedic Foot and Ankle Society (AOFAS), and Hannover Scoring System. Sixty-three patients were treated surgically. Closed reduction and minimally invasive fixation with Kirschner nails were performed in 53 patients (63.9%), and open reduction with a dorsal approach and fixation with Kirschner nails in 10 cases (15.2%). In 46 cases de medial column was fixed, in 61 cases the intermediate column, and in 42 the lateral column. Sixty-six (79.5%) of the patients had complications including both acute and late ones. Regardless of the technique used, the purpose of treatment was the anatomical reduction of the involved joints. Based on our experience, we think that the use of Kirschner nails is effective, as it provides enough stiffness and stability. In general terms, this injury is not as disabling as it had been considered in the literature. Patients consider their discomfort as tolerable and compatible with the demands of their activities of daily living and they may perform their work considering the time limitations.