Lateral Column Midfoot Injury: Do They All Need Fixation?

Abstract

Category: Trauma; Midfoot/Forefoot Introduction/Purpose: Research on midfoot injuries have primarily concentrated on the central column and the Lisfranc ligament without amassing evidence on lateral column injuries. Lateral column injuries have historically been treated with Kirschner wire fixation when encountered. Our aim in this study was to analyse lateral column injuries to the midfoot and their treatment. Methods: Setting: Multicentre observational study Methods: Data was retrospectively collected from three centres on surgically treated midfoot fracture dislocations between 2011 and 2021. Radiographs were analysed using departmental PACS. All statistics was performed using SPSS 26. Results: A total of 113 cases were diagnosed as having a lateral column injury out of the 242 cases included. On cross tabulation, there was a significant association with having a central column injury (112/113, p<.001) and 70% of cases also had an additional medial column injury. Of the 113 lateral column injuries which underwent fixation of the central column, only 13 had undergone Kirschner wire fixation of the lateral column. There were no reported loss of lateral column alignment in either the temporary fixation or no fixation groups in this study. Conclusion: Lateral column injury occurs in almost half of midfoot fractures in this study. It rarely occurs alone and is most commonly related to three column injuries. Nevertheless, following stabilisation of the central column, injuries to the lateral column are unlikely to require any further stabilisation with no reported loss of alignment in our study without lateral column fixation.