Lisfranc Injury - Surgical Fixation Facilities An Early Return To Work

2001 ◽  
Vol 87 (2) ◽  
pp. 116-119
Author(s):  
M D Brinsden ◽  
S R Smith ◽  
P H Loxdale
Keyword(s):  
Return To Work ◽  
Internal Fixation ◽  
Fracture Dislocation ◽  
Lisfranc Injury ◽  
Early Return ◽  
Foot Injury ◽  
Surgical Fixation ◽  
One Year ◽  
The Right ◽  
Lisfranc Injuries

AbstractBackgroundLisfranc injury is rare and the diagnosis maybe easily missed. This study reviews the experience of a single centre.MethodsA prospective review of patients with Lisfranc injuries presenting to a single surgeon with a specialist interest in foot and ankle surgery over a one year period.ResultsFive patients were identified-four men and one woman with a median age of 31 years (range 22-50 years). Presentation was a mean of 25 days after injury (range 3-56 days). The left foot was affected in three cases and the right in two. There was joint diastasis in four patients and fracture-dislocation in one. Three patients presented early and were treated by internal fixation and two presented late and were managed conservatively. Mean follow-up was eight months (range 4.5-12 months). Surgery resulted in a return to work by 6 months with no symptoms. The two patients managed conservatively continued to experience pain at 12 months and were unable to return to their original occupations.ConclusionInjury to the Lisfranc joint should be excluded in any foot injury. Early diagnosis and internal fixation appears to result in an earlier return to work when compared to nonoperative management.

scholarly journals Primary Arthrodesis Compared with Open Reduction and Internal Fixation for Lisfranc Injuries with the First Tarsometatarsal Joint Dislocation

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0013
Author(s):  
Ming-Zhu Zhang ◽  
Guang-rong Yu ◽  
Mark Myerson
Keyword(s):  
Internal Fixation ◽  
Open Reduction ◽  
Bodily Pain ◽  
Open Reduction Internal Fixation ◽  
Term Outcome ◽  
Lisfranc Injury ◽  
Joint Dislocation ◽  
Sf 36 ◽  
First Ray ◽  
Lisfranc Injuries

Category: Trauma Introduction/Purpose: The first tarsometatarsal (TMT) joint is very crucial for midfoot stability. To address its importance, retrospective analyses of treatment for the first TMT joint dislocation with Lisfranc injury was performed in a multi-center manner. Comparison of open reduction internal fixation (ORIF) and primary arthrodesis was conducted for the injury. Methods: This multi-center study was involved ten clinical institutions in different area of China. .From January 2003 to June 2015, 126 Lisfranc injuries with first TMT joint dislocation underwent surgical intervention. Of this group, forty one (32.5%) feet were first TMT joint dislocation only. Eighty five feet were first TMT joint dislocation and fractures. They were 76 males (60.3%) and 50 females (39.7%) with a mean age of 45.5 (range, 20-87) years. The duration from injury to surgery is 11.7 (range, 4-26) days. Two groups were divided by surgery methods as open reduction internal fixation (ORIF) group and primary arthrodesis group. Ninety two patients were performed by ORIF, while primary arthrodesis group including 34 cases. Outcome measures included clinical examination, radiographs, AOFAS ankle-hindfoot scores, visual analogue scale (VAS) and SF-36 scores. Complications and revision rate were analyzed as well. Results: 126 patients were followed up for 29.5 months. At 1.5 years postoperatively, the AOFAS score was 79 and 85 in ORIF group and arthrodesis group.The VAS score was 3.1 separately in two groups.The mean Physical Functioning sores of SF-36 was 80.3 points and 83.5• points. The Bodily Pain score of SF-36 was 76.1 points and 84.6• points.Redislocation of first tarsometarsal joint were observed in 16 cases among ORIF group.36 patients in ORIF group had pain in midfoot, eight of them had persistent pain with the development of deformity or osteoarthrosis.No redislocation and no hardware failure was identified in arthrodesis group Conclusion: Primary stable arthrodesis of the first ray gives a better short and medium term outcome than open reduction and internal fixation for Lisfranc injury with the first ray dislocation. Possible complication and revision could be avoided by primary arthrodesis for dislocated first ray injuries.

scholarly journals Primary Arthrodesis Compared with Open Reduction and Internal Fixation for Lisfranc Injuries with the First Tarsometatarsal Joint Dislocation: A Randomized Controlled Trial

2019 ◽  
Vol 4 (4) ◽  
pp. 2473011419S0007
Author(s):  
Mingzhu Zhang ◽  
Guangrong Yu
Keyword(s):  
Internal Fixation ◽  
Open Reduction ◽  
Controlled Trial ◽  
Bodily Pain ◽  
Lisfranc Injury ◽  
Joint Dislocation ◽  
Tarsometatarsal Joint ◽  
Sf 36 ◽  
First Ray ◽  
Lisfranc Injuries

Category: Midfoot/Forefoot, Trauma Introduction/Purpose: Prospective analyses of treatment for the first tarsometatarsal joint dislocation with Lisfranc injury. Comparison of open reduction internal fixation (ORIF) and primary arthrodesis was conducted for the injury. Methods: 78 Lisfranc injuries with first tarsometatarsal joint dislocation underwent surgical intervention. They were 46 males and 32 females with mean age of 41.2 years. Two groups were randomized by ORIF group and primary arthrodesis group. 43 patients were performed by ORIF, while primary arthrodesis group including 35 cases. Outcome measures included radiographs, AOFAS scores, VAS and SF-36 scores. Complications and revision rate were analyzed also. Results: 73 patients were followed up for 21 months. At 1.5 years postoperatively, the AOFAS score was 75 and 83 in ORIF group and arthrodesis group. The VAS score was 3.0 and 2.1 separately in two groups. The mean Physical Functioning sores of SF- 36 was 81.2 points and 84.1 points. The Bodily Pain score of SF-36 was 79.3 points and 85.2 points. Redislocation of first tarsometarsal joint were observed in 11 cases among ORIF group.31 patients in ORIF group had pain in midfoot, six of them had persistent pain with the development of deformity or osteoarthrosis. No redislocation and no hardware failure was identified in arthrodesis group. Conclusion: Primary stable arthrodesis of the first ray gives a better short and medium term outcome than open reduction and internal fixation for Lisfranc injury with the first ray dislocation. Possible complication and revision could be avoided by primary arthrodesis for dislocated first ray injuries.

Surgical Treatment of Trans-Scaphoid, Transcapitate, Transtriquetral, Perilunate Fracture–Dislocation with Open Reduction, Internal Fixation and Lunotriquetral Ligament Repair

2008 ◽  
Vol 33 (3) ◽  
pp. 377-379 ◽  
Author(s):  
E. SANDOVAL ◽  
D. CECILIA ◽  
E. GARCIA-PAREDERO
Keyword(s):  
Internal Fixation ◽  
Open Reduction ◽  
Suture Anchor ◽  
Open Reduction Internal Fixation ◽  
Fracture Dislocation ◽  
Ligament Repair ◽  
Motorcycle Accident ◽  
Lunotriquetral Ligament ◽  
Perilunate Fracture Dislocation ◽  
The Right

This paper presents a rare case of trans-scaphoid, transcapitate, transtriquetral, perilunate fracture–dislocation of the right wrist as a result of a motorcycle accident. Open reduction and internal fixation of the scaphoid and capitate with one screw was performed and the lunotriquetral ligament was repaired using a suture anchor.

A Comparison of Complications and Reoperations Between Open Reduction and Internal Fixation Versus Primary Arthrodesis Following Lisfranc Injury

2021 ◽  
pp. 193864002110582
Author(s):  
Eric So ◽  
Jonathan Lee ◽  
Michelle L. Pershing ◽  
Anson K. Chu ◽  
Matthew Wilson ◽  
...  
Keyword(s):  
Internal Fixation ◽  
Open Reduction ◽  
Retrospective Chart Review ◽  
Reoperation Rate ◽  
Complication Rates ◽  
Lisfranc Injury ◽  
Significant Difference ◽  
Lisfranc Injuries ◽  
Reoperation Rates

There is a lack of consensus in the literature regarding optimal treatment methods for Lisfranc injuries, and recent literature has emphasized the need to compare open reduction and internal fixation (ORIF) with primary arthrodesis (PA). The purpose of the current study is to compare reoperation and complication rates between ORIF and PA following Lisfranc injury in a private, outpatient, orthopaedic practice. A retrospective chart review was performed on patients undergoing operative intervention for Lisfranc injury between January 2009 and September 2015. A total of 196 patients met the inclusion criteria (130 ORIF, 66 PA), with a mean follow-up of 61.3 and 81.7 weeks, respectively. The ORIF group had a higher reoperation rate than the PA group, due to hardware removal. When hardware removals were excluded, the reoperation rate was similar. Postsurgical complications were compared between the 2 groups with no significant difference. In conclusion, ORIF and PA had similar complication rates. When hardware removals were excluded, the reoperation rates were similar, although hardware removals were more common in the ORIF group compared with the PA group. Levels of Evidence: Level III

scholarly journals Inter- and intraobserver reliability of non-weight-bearing foot radiographs compared with CT in Lisfranc injuries

2020 ◽  
Vol 140 (10) ◽  
pp. 1423-1429
Author(s):  
Ville T. Ponkilainen ◽  
Nikke Partio ◽  
Essi E. Salonen ◽  
Antti Riuttanen ◽  
Emma- Liisa Luoma ◽  
...  
Keyword(s):  
Interobserver Reliability ◽  
Weight Bearing ◽  
Clinical Signs ◽  
Intraobserver Reliability ◽  
Level Of Evidence ◽  
Severe Injuries ◽  
Lisfranc Injury ◽  
Foot Injury ◽  
Wide Range ◽  
Lisfranc Injuries

Abstract Background Injury of the tarsometatarsal (TMT) joint complex, known as Lisfranc injury, covers a wide range of injuries from subtle ligamentous injuries to severely displaced crush injuries. Although it is known that these injuries are commonly missed, the literature on the accuracy of the diagnostics is limited. The diagnostic accuracy of non-weight-bearing radiography (inter- or intraobserver reliability), however, has not previously been assessed among patients with Lisfranc injury. Methods One hundred sets of foot radiographs acquired due to acute foot injury were collected and anonymised. The diagnosis of these patients was confirmed with a CT scan. In one-third of the radiographs, there was no Lisfranc injury; in one-third, a nondisplaced (< 2 mm) injury; and in one-third, a displaced injury. The radiographs were assessed independently by three senior orthopaedic surgeons and three orthopaedic surgery residents. Results Fleiss kappa (κ) coefficient for interobserver reliability resulted in moderate correlation κ = 0.50 (95% CI: 0.45– 0.55) (first evaluation) and κ = 0.58 (95% CI: 0.52–0.63) (second evaluation). After three months, the evaluation was repeated and the Cohen’s kappa (κ) coefficient for intraobserver reliability showed substantial correlation κ = 0.71 (from 0.64 to 0.85). The mean (range) sensitivity was 76.1% (60.6–92.4) and specificity was 85.3% (52.9–100). The sensitivity of subtle injuries was lower than severe injuries (65.4% vs 87.1% p = 0.003). Conclusions Diagnosis of Lisfranc injury based on non-weight-bearing radiographs has moderate agreement between observers and substantial agreement between the same observer in different moments. A substantial number (24%) of injuries are missed if only non-weight-bearing radiographs are used. Nondisplaced injuries were more commonly missed than displaced injuries, and therefore, special caution should be used when the clinical signs are subtle. Level of evidence III.

scholarly journals Cost Comparison and Complication Rate of Lisfranc Injuries Treated with Open Reduction Internal Fixation versus Primary Arthrodesis

2018 ◽  
Vol 6 (7_suppl4) ◽  
pp. 2325967118S0012
Author(s):  
Brandon Barnds ◽  
William Tucker ◽  
Brandon L. Morris ◽  
John Paul Schroeppel ◽  
Scott M. Mullen ◽  
...  
Keyword(s):  
Internal Fixation ◽  
Complication Rate ◽  
Average Cost ◽  
Open Reduction ◽  
Open Reduction Internal Fixation ◽  
Cost Of Care ◽  
Hardware Removal ◽  
Lisfranc Injury ◽  
Hardware Complications ◽  
Lisfranc Injuries

Objectives: Controversy exists regarding optimal primary management of Lisfranc injuries. Whether open reduction internal fixation or primary arthrodesis is superior remains unknown. Our retrospective study uses a private payer database to compare cost, complication rate, and hardware removal rate in Lisfranc injuries treated with primary open reduction internal fixation or primary arthrodesis. Methods: Utilizing data mining software created by a private organization, a national insurance database of approximately 23.5 million orthopedic patients was retrospectively queried for subjects who were diagnosed with a Lisfranc injury from 2007-2016 based on international classification of diseases (ICD) codes for tarsometatarsal (TMT) dislocation (PearlDiver, Colorado Springs, CO). Patients with TMT dislocations then progressed on to either non-operative treatment, open reduction internal fixation, or primary arthrodesis. Associated treatment costs based on diagnosis codes were followed after initial diagnosis and t-tests were used to determine statistical significance. Subgroups were then created based on having at least one complication ICD or current procedural terminology (CPT) code after the beginning of treatment, which included: hemorrhage, infection, nonunion, malunion, thromboembolism, wound and hardware complications, or amputation. Additionally, patients undergoing implant removal were identified by CPT code for removal of hardware performed after the index procedure. Complication and hardware removal rates were compared with chi-square test. Results: 2205 subjects with a diagnosis of Lisfranc injury were identified in the database. 1248 patients underwent non-operative management, 670 underwent open reduction internal fixation, and 212 underwent primary arthrodesis. The average cost of care associated with primary arthrodesis was greater ($5,005.82) than for open reduction internal fixation ($3,961.97, P=0.045). The overall complication rate was 23.1% (155/670) for open reduction internal fixation and 30.2% (64/212) for primary arthrodesis ( P=0.04). Rates of hardware removal independent of complications were 43.6% (292/670) for open reduction internal fixation and 18.4% (39/212) for arthrodesis ( P<0.001). Furthermore, 2.5% (17/670) patients in the open reduction internal fixation group progressed to arthrodesis at a mean of 308 days, average cost of care associated with this group of patients was $9,505.12. Conclusion: Primary arthrodesis for the management of acute Lisfranc injuries is both significantly more expensive and has a higher complication rate than open reduction internal fixation. Open reduction internal fixation demonstrated a low rate of progression to arthrodesis, although there was a high rate of hardware removal, which may represent a planned second procedure in the management of a substantial number of patients treated with open reduction internal fixation.

scholarly journals Clavicle fracture nonunion in the paediatric population: a systematic review of the literature

2018 ◽  
Vol 12 (1) ◽  
pp. 2-8 ◽  
Author(s):  
K. Hughes ◽  
J. Kimpton ◽  
R. Wei ◽  
M. Williamson ◽  
A. Yeo ◽  
...  
Keyword(s):  
Systematic Review ◽  
Clavicle Fracture ◽  
Paediatric Population ◽  
Level Of Evidence ◽  
Fracture Nonunion ◽  
Fracture Nonunions ◽  
Surgical Fixation ◽  
One Year ◽  
The Right ◽  
Meta Analyses

Aims Clavicle fracture nonunions are extremely rare in children. The aim of this systematic review was to assess what factors may predispose children to form clavicle fracture nonunions and evaluate the treatment methods and outcomes. Methods We performed a systematic review according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, aiming to find papers reporting clavicle fracture nonunion in children under the age of 18 years. Data was collected on patient demographics, fracture type, mechanism of injury (MOI), surgical intervention and reported outcome. Two independent reviewers evaluated all the data. Results A total of 13 articles reporting 21 cases of clavicle fracture nonunion were identified. The mean age at time of injury was 11.4 years (4 to 17). Falls were the most common MOI. The majority of nonunions occurred after displaced fractures on the right side. Six were refractures. Mean time of presentation following injury was 13.5 months (4 to 60). In all, 16 were treated surgically. Radiographic union was eventually achieved in 12 cases, with functional outcome satisfactory in all cases. Conclusion Clavicle nonunion is an extremely rare but possible complication in children. The majority occur after displaced right-sided fractures or refractures and present around one year after injury. Surgical fixation provides good radiographic healing and functional outcomes. Level of evidence IV

scholarly journals Management of complete dislocation of tarsal scaphoid without fracture

2017 ◽  
Vol 3 (3) ◽  
pp. 371
Author(s):  
M. A. Q. Ansari ◽  
Shivanand Mayi ◽  
Sachin A. Shah
Keyword(s):  
Internal Fixation ◽  
Open Reduction ◽  
Weight Bearing ◽  
Kirschner Wire ◽  
Clinical Results ◽  
Fracture Dislocation ◽  
History Of ◽  
One Year ◽  
The One ◽  
Complete Dislocation

<p class="abstract"><strong>Background:</strong> Injuries to the mid tarsal joints usually occur in the form of various combinations such as fracture, fracture subluxation, and fracture dislocation. Dislocations of navicular without fracture are rare injuries, minimal literatures exist, which describe the probable mechanism of injury and optimal treatment<span lang="EN-IN">.</span></p><p class="abstract"><strong>Methods:</strong> Four patients with complete dislocation of navicular without fracture presented to us following a history of trauma. The diagnosis was confirmed by radiology and further details were studied by CT scans. One injury was open and the rest were closed. One had associated fracture of talus and two had metatarsal fracture and one was purely isolated navicular dislocation without any associated injury. All were initially stabilized in a below knee plaster of paris slab and foot end elevated. All were successfully treated surgically under spinal anesthesia with open reduction and internal fixation with Kirschner wires through a dorsomedial approach. Postoperative immobilization was continued for twelve weeks then gradual mobilization begun followed by physiotherapy.<strong></strong></p><p class="abstract"><strong>Results:</strong> All patients had good clinical results with two patients resuming their work within twelve weeks and the one with open wound took twenty weeks for resuming his original work. One with associated talar fracture later had to undergo subtalar arthrodesis for pain in the foot while weight bearing after one year of surgery for navicular dislocation<span lang="EN-IN">. </span></p><p class="abstract"><strong>Conclusions:</strong> Open reduction and internal fixation with Kirschner wire is an effective way of managing patients with complete dislocation of tarsal navicular for early resuming of the functions and return to work<span lang="EN-IN">.</span></p>

scholarly journals Cost Comparison and Complication Rate of Lisfranc Injuries Treated with Open Reduction Internal Fixation versus Primary Arthrodesis

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0002
Author(s):  
Brandon Barnds ◽  
Bryan Vopat ◽  
Scott Mullen ◽  
Paul Schroeppel ◽  
Brandon Morris ◽  
...  
Keyword(s):  
Internal Fixation ◽  
Complication Rate ◽  
Average Cost ◽  
Open Reduction ◽  
Open Reduction Internal Fixation ◽  
Cost Of Care ◽  
Hardware Removal ◽  
Lisfranc Injury ◽  
Hardware Complications ◽  
Lisfranc Injuries

Category: Midfoot/Forefoot Introduction/Purpose: Controversy exists regarding optimal primary management of Lisfranc injuries. Whether open reduction internal fixation or primary arthrodesis is superior remains unknown. Our retrospective study uses a private payer database to compare cost, complication rate, and hardware removal rate in Lisfranc injuries treated with primary open reduction internal fixation or primary arthrodesis. Methods: Utilizing data mining software created by a private organization, a national insurance database of approximately 23.5 million orthopedic patients was retrospectively queried for subjects who were diagnosed with a Lisfranc injury from 2007-2016 based on international classification of diseases (ICD) codes for tarsometatarsal (TMT) dislocation (PearlDiver, Colorado Springs, CO). Patients with TMT dislocations then progressed on to either non-operative treatment, open reduction internal fixation, or primary arthrodesis. Treatment costs based on diagnosis codes were followed after initial diagnosis and t-tests were used to determine statistical significance. Subgroups were created based on having at least one complication ICD or current procedural terminology (CPT) code after the beginning of treatment, which included: hemorrhage, infection, nonunion, malunion, thromboembolism, wound and hardware complications, or amputation. Additionally, patients undergoing implant removal were identified by CPT code for removal of hardware performed after the index procedure. Complication and hardware removal rates were compared with chi-square test. Results: 2205 subjects with a diagnosis of Lisfranc injury were identified in the database. 1248 patients underwent non-operative management, 670 underwent open reduction internal fixation, and 212 underwent primary arthrodesis. The average cost of care associated with primary arthrodesis was greater ($5,005.82) than for open reduction internal fixation ($3,961.97, P=0.045). The overall complication rate was 23.1% (155/670) for open reduction internal fixation and 30.2% (64/212) for primary arthrodesis (P=0.04). Rates of hardware removal independent of complications were 43.6% (292/670) for open reduction internal fixation and 18.4% (39/212) for arthrodesis (P<0.001). Furthermore, 2.5% (17/670) patients in the open reduction internal fixation group progressed to arthrodesis at a mean of 308 days, average cost of care associated with this group of patients was $9,505.12. Conclusion: Primary arthrodesis for the management of acute Lisfranc injuries is both significantly more expensive and has a higher complication rate than open reduction internal fixation. Open reduction internal fixation demonstrated a low rate of progression to arthrodesis, although there was a high rate of hardware removal, which may represent a planned second procedure in the management of a substantial number of patients treated with open reduction internal fixation.

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