Abstract
The Forgotten Brick: Case Report of a Lisfranc Injury with "Pericuneiform" Dislocation
Highlights
DiscussionAnatomical reduction of the Lisfranc joint line is crucial in displaced Lisfranc injuries
The Lisfranc joint complex forms the transverse arch of the foot
The Lisfranc joint complex is fundamental for both stability and flexibility of the foot, whereas the intermediate cuneiform anchors as its keystone
Summary
An anatomical position of the Lisfranc joint line even with weight-bearing is crucial in Lisfranc injuries and a requirement of conservative therapy. Quite often in the case of less obvious, primarily ligamentous injuries, an unstable injury is diagnosed, surgical treatment is clearly indicated. In a review from 2019, Moracia-Ochagavía, et al elaborated a management approach recommending unstable osseous injuries for ORIF and ligamentous injuries for primary arthrodesis [5]. Our particular case could not been fitted into those guidelines due to a lack of classification of proximal dislocation injuries [10]. We sought other parameters to apply, whereby two considerations proved to be determining: On the one hand, through the dislocation of the intermediate cuneiform, the dorsal ligamentous apparatus was ruptured, which, as described above, is weakly developed and cannot be repaired [2]. In a synopsis of these factors, the primary arthodesis with preservation of stability was considered a priority and the preferred treatment of the medial column. To minimise the risk of pseudarthrosis in the area of arthrodesis, we used a combination of compression screw and locking plate for fixation [18,19]
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