Anatomy of the 1st and 2nd Lisfranc joint surface and its clinical significance

Abstract

Objective To explore anatomic features of the joint area of the first and second tarsometatarsal joints provide basis data for the treatment of tarsometatarsal joint injury. Methods Twenty normal adult feet specimens were dissected between the tarsometatarsal joint and ensure the integrity of tarsometatarsal joint surface cartilage to perform prospective study from June 2011 to December 2011.The specimens were divided into groups A and B by random digital table method, 10 feet in each group. The joint area of the first and second tarsometatarsal joints were measured and analyzed respectively. Group A: with 1.0 mm Kirschner wire and 4.0 mm cannulated screws through the first and second tarsometatarsal joint surface and measured the articular surface damage range. Group B with 2 Kirschner wire and cannulated screws as group A. Results The joint area of the base of the first and second metatarsal were (3.13±0.32)cm2 and (2.15±0.31)cm2, respectively. The joint area of the distal of the first and second cuneiform were(3.44±0.40 )cm2 and (1.70±0.30 )cm2, respectively. In group A, the injury area proportions of screw across the first and second metatarsal bone were 5.11%±0.26% and 7.44%±0.86%. The injury area proportion of screw across the first and second cuneiform bone were 4.65%±0.58% and 9.41%±0.45%. In group B, the injury area proportions of screw across the first metatarsal and cuneiform bone were 10.22%±0.67% and 9.30%±0.32%. In 6 feet of group B, the injury area proportion of screw across the second metatarsal and cuneiform bone were 13.32%±0.38% and 17.48%±0.84%. In the other four feet of group B, the injury of the second tarsometatarsal joints surface was not only the diameter of the screws, but the joint surfaces also fracture. The injury area proportions of screw across the second metatarsal and cuneiform bones were 16.45%±0.57% and 20.07%±0.55%. Conclusions Mean surface area of the first metatarsal base was smaller than that of the first cuneiform. Mean surface area of the second metatarsal base was larger than that of the second cuneiform. Key words: Foot joints; Joint surface; Anatomy; Internal fixators