Open reduction combined with a variable angle foot plate for treatment of acute Lisfranc frac-ture-dislocation

Abstract

Objective To analyze the clinical outcomes of a standard protocol of open reduction and internal fixation using a variable angle foot plate for a consecutive series of patients with acute Lisfranc joint injury. Methods This study retrospectively evaluated the clinical outcomes of 11 Chinese patients (13 feet) with acute Lisfranc joint injury who had been treated by open reduction and internal fixation with a variable angle foot plate from December 2016 to June 2017 at Department of Orthopaedics, West China Hospital.They were 8 men (10 feet) and 3 women (3 feet), aged from 19 to 57 years (average, 36.4 years).Of them, 10 were complicated with fracture of metatarsus, 6 with cuneiform fracture and/or dislocation, 4 with cuboid fracture, and one with cuboid fracture.According to the Myerson classification for Lisfranc frac-ture-dislocations, one case (one foot) belonged to type A, 2 (2 feet) to type B1, 5 (6 feet) to type B2, 2 (3 feet) to type C1 and one (one foot) to type C2.The outcomes were evaluated using the visual analogue scale (VAS) and the midfoot scores of American Orthopedic Foot and Ankle Society (AOFAS). Results This cohort was followed up for 18 to 24 months (average, 22 months).Their VAS scores were decreased signif-icantly from preoperative 7.3±1.2 (from 6 to 9) to postoperative 1.2±0.2 (from 0 to 2) (P<0.05); their AOFAS midfoot scores were increased significantly from preoperative 0 to postoperative 84.6±4.6 (P< 0.05).Anatomic reduction was obtained in all the patients and all the fractures united successfully without any delayed union or nonunion.Superficial necrosis of the wound edge occurred in 2 cases without deep in-fection; skin anesthesia occurred in 2 and skin hypesthesia in 4, indicating a lesion of the superficial peroneal nerve. Conclusion Fixation of acute Lisfranc joint injury with a variable angle foot plate can lead to rigid stability, precise reduction and satisfactory short-term clinical outcomes. Key words: Foot; Wounds and injuries; Bone plate; Lisfranc