Analysis of clinical outcome and prognosis for Lisfranc joint fracture and dislocation according to the injury mechanism and treatment method [in Korean]

Park, Hyun-Woo; Yi, Hyung Suk

Affiliations

¹Department of Orthopaedic Surgery, Dankook University Hospital, Cheonan, Korea

Abstract and keywords

Purpose: The purpose of this study was to assess the treatment outcomes and prognosis of Lisfranc joint fracture and dislocation according to the mechanism of injury and treatment method.

Materials and Methods: Twenty six patients with Lisfranc fracture-dislocation who had been treated surgically were included in this retrospective study. The patients were divided into two groups according to mechanism of injury: direct crushing injury (16 patients) and indirect rotational or compressive injury (10 patients). The patients were also divided into three groups according to the surgical methods. The parameters used were radiographic evaluation, patients’ subjective satisfaction levels, length of hospital stay, and the American Orthopaedic Foot and Ankle Society (AOFAS) midfoot score. Statistical analysis was performed.

Results: The mean postoperative AOFAS midfoot score was 78.7. The mean length of stay was 39.6 days. Statistically significant differences in subjective satisfaction, AOFAS midfoot score, and length of hospital stay were observed between the two groups (p<0.05). However, no significance differences were observed between the three groups who were divided according to the different surgical methods (p>0.05).

Conclusion: Mechanism of trauma and the severity of soft-tissue injury were significant prognostic factors affecting the surgical outcomes of Lisfranc joint fracture and dislocation.

Keywords: Lisfranc joint, Fracture and dislocation, Injury mechanism

Links

DOI: 10.14193/jkfas.2014.18.3.124

History

Received: 2014-03-31

Revised: 2014-04-26

Accepted: 2014-05-29

Cited Works (12)

Year	Entry
2002	Mulier T, Reynders P, Dereymaeker G, Broos P. Severe lisfranc injuries: primary arthrodesis of ORIF? Foot Ankle Int. 2002;23(10):902-905.
1982	Hardcastle PH, Reschauer R, Kutscha-Lissberg E, Schoffmann W. Injuries to the tarsometatarsal joint: incidence, classification and treatment. J Bone Joint Surg. 1982;64B(3):349-356.
1990	Adelaar RS. The treatment of tarsometatarsal fracture-dislocation. Instr Course Lect. 1990;39:141-145.
2003	Thompson MC, Mormino MA. Injury to the tarsometatarsal joint complex. J Am Acad Orthop Surg. 2003;11(4):260-267.
2001	Richter M, Wippermann B, Krettek C, Schratt HE, Hufner T, Thermann H. Fractures and fracture dislocations of the midfoot: occurrence, causes and long-term results. Foot Ankle Int. 2001;22(5):392-398.
1986	Myerson MS, Fisher RT, Burgess AR, Kenzora JE. Fracture dislocations of the tarsometatarsal joints: end results correlated with pathology and treatment. Foot Ankle. 1986;6(5):225-242.
1999	Myerson MS. The diagnosis and treatment of injury to the tarsometatarsal joint complex. J Bone Joint Surg. 1999;81B(5):756-763.
2013	Demirkale I, Tecimel O, Celik I, Kilicarslan K, Ocguder A, Dogan M. The effect of the Tscherne injury pattern on the outcome of operatively treated Lisfranc fracture dislocations. Foot Ankle Surg. September 2013;19(3):188-193.
2000	Thordarson DB. Fractures of the midfoot and forefoot. In: Myerson MS, ed. Foot and Ankle Disorders. Vol 2. Philadelphia, PA: W.B. Saunders Company; 2000:1265-1296.
2003	Perugia D, Basile A, Battaglia A, Stopponi M, De Simeonibus AUM. Fracture dislocations of Lisfranc’s joint treated with closed reduction and percutaneous fixation. Int Orthop. 2003;27(1):30-35.
2000	Kuo RS, Tejwani NC, DiGiovanni CW, Holt SK, Benirschke SK, Hansen ST Jr, Sangeorzan BJ. Outcome after open reduction and internal fixation of Lisfranc joint injuries. J Bone Joint Surg. November 2000;82A(11):1609-1618.
2013	Schepers T, Oprel PP, Van Lieshout EMM. Influence of approach and implant on reduction accuracy and stability in Lisfranc fracture-dislocation at the tarsometatarsal joint. Foot Ankle Int. May 2013;34(5):705-710.