Abstract
Fracture dislocations involving the Lisfranc joint are rare; they represent only 0.2% of all the fractures. There is no consensus about the surgical management of these lesions in the medical literature. However, both anatomical reduction and tarsometatarsal stabilization are essential for a good outcome. In this clinical study, five consecutive patients with a diagnosis of Lisfranc low-energy lesion were treated with a novel surgical technique characterized by minimal osteosynthesis performed through a minimally invasive approach. According to the radiological criteria established, the joint reduction was anatomical in four patients, almost anatomical in one patient (#4), and nonanatomical in none of the patients. At the final follow-up, the AOFAS score for the midfoot was 96 points (range, 95–100). The mean score according to the VAS (Visual Analog Scale) at the end of the follow-up period was 1.4 points over 10 (range, 0–3). The surgical technique described in this clinical study is characterized by the use of implants with the utilization of a novel approach to reduce joint and soft tissue damage. We performed a closed reduction and minimally invasive stabilization with a bridge plate and a screw after achieving a closed anatomical reduction.
Highlights
Fracture dislocations involving the Lisfranc joint are rare; they represent only 0.2% of all the fractures [1]
Both anatomical reduction and tarsometatarsal stabilization are essential for a good outcome [3, 14,15,16]
A large number of treatment options have been proposed for this type of fracture dislocations, such as fixation with percutaneous pegs and/or screws; other surgeons prefer open reduction and internal fixation (RAFI) [14, 16,17,18]
Summary
Fracture dislocations involving the Lisfranc joint are rare; they represent only 0.2% of all the fractures [1]. Most of the lesions occur after a high-energy trauma, such as motor vehicle accidents, work accidents, and falls from heights, they can be associated with low-energy accidents, such as strains, in athletes and elderly people [2] In these cases, fracture dislocations may be mild and less severe than those caused by heavy trauma, but if they are not adequately managed they may be associated with significant morbidity [3]. A large number of treatment options have been proposed for this type of fracture dislocations, such as fixation with percutaneous pegs and/or screws; other surgeons prefer open reduction and internal fixation (RAFI) [14, 16,17,18] The objective of this case series is to study five consecutive patients with a diagnosis of Lisfranc low-energy lesion treated with a novel surgical technique characterized by minimal osteosynthesis performed through a minimally invasive approach; the focus will be the analysis of the clinical and radiological results
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