scholarly journals Lisfranc fracture-dislocations: current management

2019 ◽  
Vol 4 (7) ◽  
pp. 430-444 ◽  
Author(s):  
Inmaculada Moracia-Ochagavía ◽  
E. Carlos Rodríguez-Merchán
Keyword(s):  
Surgical Treatment ◽  
Weight Bearing ◽  
Correct Diagnosis ◽  
Foot Deformities ◽  
Current Management ◽  
Lisfranc Joint ◽  
Fracture Dislocations ◽  
Post Traumatic ◽  
The Stability ◽  
Lisfranc Injuries

It is essential to know and understand the anatomy of the tarsometatarsal (TMT) joint (Lisfranc joint) to achieve a correct diagnosis and proper treatment of the injuries that occur at that level. Up to 20% of Lisfranc fracture-dislocations go unnoticed or are diagnosed late, especially low-energy injuries or purely ligamentous injuries. Severe sequelae such as post-traumatic osteoarthritis and foot deformities can create serious disability. We must be attentive to the clinical and radiological signs of an injury to the Lisfranc joint and expand the study with weight-bearing radiographs or computed tomography (CT) scans. Only in stable lesions and in those without displacement is conservative treatment indicated, along with immobilisation and initial avoidance of weight-bearing. Through surgical treatment we seek to achieve two objectives: optimal anatomical reduction, a factor that directly influences the results; and the stability of the first, second and third cuneiform-metatarsal joints. There are three main controversies regarding the surgical treatment of Lisfranc injuries: osteosynthesis versus primary arthrodesis; transarticular screws versus dorsal plates; and the most appropriate surgical approach. The surgical treatment we prefer is open reduction and internal fixation (ORIF) with transarticular screws or with dorsal plates in cases of comminution of metatarsals or cuneiform bones. Cite this article: EFORT Open Rev 2019;4:430-444. DOI: 10.1302/2058-5241.4.180076

scholarly journals Comparative analysis of weight-bearing function of lower extremities in children with recurrences of congenital equinovarus clubfoot after surgical treatment by «traditional» methods and Ponseti method

2021 ◽  
pp. 9-17
Author(s):  
Sergij Khmyzov ◽  
Genadij Kykosh ◽  
Olena Karpinska ◽  
Mykhaylo Karpinsky
Keyword(s):  
Surgical Treatment ◽  
Weight Bearing ◽  
Ponseti Method ◽  
Foot Deformities ◽  
Traditional Methods ◽  
Congenital Talipes Equinovarus ◽  
Initial Surgery ◽  
Group I ◽  
Talipes Equinovarus ◽  
Group Ii

Congenital equinovarus clubfoot (EVC) is the second most common congenital anomaly of the musculoskeletal system in children and one of the most common causes of childhood disability in Ukraine. The frequency of EVC reaches 1–3 cases per 1 000 newborns (35–40 % of all foot deformities). Objective. To determine the features of the children ability with EVC recurrences, before and after surgical treatment by «traditional» methods and Ponseti method. Methods. Biomechanical examinations of 65 children with EVC recurrences were performed. They were divided into two groups: group I (33 patients) — treated by «traditional» methods, which provided initial surgery, in order to completely correct all components of the deformity; group II (32 patients) — treatment by Ponseti method. Weight-bearing function was studied for all patients, before treatment, after 6 and 12 months after surgery, with statography. Results. It was determined that the standing parameters in the groups were not statistically different. After 6 months after the treatment, according to the statograms, the weight-bearing displacement remained, under the conditions of two weight-bearing standing towards the contralateral limb, in both groups of patients. In group I, after treatment, this parameter did not change (p = 0.924), and in group II it decreased by (2.7 ± 4.7) % (p = 0.013). Weight-bearing on the operated limb in both groups, in 12 months from surgery increased by 45 %. Conclusions. In patients, after treatment of EVC recurrences by Ponseti method, the weight-bearing function indicators, in the case of two weight-bearing standing, changed statistically significant. During the recovery process, when patients began to load the operated foot, a slight deterioration of standing parameters was observed in patients of group I in 6 months from surgery. In patients of group II, a complete restoration of statographic parameters occurred earlier, in 6 months, a normalization of weight-bearing and stability was observed. Thus, it can be argued that the use of Ponseti method in the complex treatment of EVC allows to restore the ability of weight bearing much earlier than with the «traditional» method. Key words. Congenital talipes equinovarus, children, Ponseti method, statography.

A clinical case of surgical correction of post-traumatic aphakia

2021 ◽  
pp. 191-194
Author(s):  
K.S. Khusanbaev ◽  
◽  
A.F. Yusupov ◽  
A.A. Abdushukurova ◽  
T.F. Sultonmurodov ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Foreign Body ◽  
Clinical Case ◽  
Posterior Chamber ◽  
Combined Method ◽  
Clinical Observations ◽  
Corneal Scar ◽  
Post Traumatic ◽  
The Stability ◽  
Iol Fixation

Purpose. To present a clinical case of surgical treatment of post-traumatic aphakia by the method of corneoscleral IOL fixation using the combined method of Kanabrava and Kozhukhov. Material and methods. In March 2021, patient A., born in 1992, turned to the RSSPCEM. diagnosed with OS Condition after a penetrating injury to the eye. Corneal scar. Post-traumatic aphakia. Foreign body (non-metallic) driven into the retina. A decision was made on OS surgical treatment of aphakia by the method of transscleral IOL fixation as the most gentle method, taking into account the paracentral scar of the cornea. And do not remove the foreign body, but additionally restrict it with laser coagulates. Results. On the 14th day after the operation, visual acuity OS 0.7, IOP 18. The eye is calm, there is a scar on the cornea in the paraoptic zone, transparent in the rest of the zone, the anterior chamber is deep, the iris is subatrophic, the pupil is 3 mm, deformed, the IOL is in the posterior chamber, centered. The fundus of the eye: the optic disc is pale pink, the boundaries are clear, the reflex is blurred in the macular zone, the foreign body is limited by pigmented laser coagulates. The standard postoperative drop regimen is recommended. Conclusions. 1. Corneoscleral fixation of the IOL according to the combined method of Canabrava and Kojuhov in the aphakic eye in complicated cases allows to achieve good refractive results with the developed technique of execution. 2. Preliminary laser limitation of an encapsulated non-metallic foreign body gives confidence in the stability of the retina in the intra- and postoperative period. 3. Further clinical observations are required using the above-described surgical technique for correcting aphakia Key words: сorneoscleral fixation, aphakia, Canabrava, Kojuhov.

scholarly journals Comparison of Fixation Stability of the Novel Lisfranc Plate to Transarticular Screws

2017 ◽  
Vol 2 (3) ◽  
pp. 2473011417S0003
Author(s):  
Stephen Shymon ◽  
Thomas Harris ◽  
Spenser Cassinelli ◽  
Edward Ebramzadeh ◽  
John Fleming ◽  
...  
Keyword(s):  
Motion Tracking ◽  
Three Dimensional ◽  
Axial Loading ◽  
Fixation Method ◽  
Implant Fixation ◽  
Lisfranc Joint ◽  
Second Metatarsal ◽  
Fixation Stability ◽  
The Stability ◽  
Lisfranc Injuries

Category: Midfoot/Forefoot, Trauma Introduction/Purpose: The objective of this study was to compare the stability of fixation of ligamentous Lisfranc injuries stabilized using two devices: a novel Lisfranc plate and conventional transarticular screws. Methods: A biomechanical cadaver model was developed to compare the fixation stability of a novel Lisfranc plate to that of traditional fixation, using transarticular screws. Thirteen pairs of cadaveric specimens were tested intact, after a simulated injury, and after implant fixation. Optical motion tracking was used to measure the three dimensional (3D) motion between each of the following four bones: first metatarsal, second metatarsal, first cuneiform, and second cuneiform. Testing included both cyclic abduction loading and cyclic axial loading. Results: Both the Lisfranc plate and screw fixation method provided stability such that the average 3D motions across the Lisfranc joint (between the second metatarsal and the first cuneiform), were between 0.2 and 0.4 mm under cyclic abduction loading and between 0.4 and 0.5 mm under cyclic axial loading. Comparing the stability of fixation between the Lisfranc plate and the screws, the differences in motion were all 0.3 mm or lower, with no significant differences (p > 0.16). Conclusion: Average 3D motions of the Lisfranc joint were 0.5 mm or below, whether fixed with the Lisfranc plate or the screws. Therefore, the Lisfranc plate provided comparable stability to the transarticular screws, which have been established as the gold standard for arthrodesis in Lisfranc injuries. Due to its anatomical placement, the Lisfranc plate may provide adequate support without risk of iatrogenic injury to the articular cartilage.

652 SURGICAL TREATMENT OF POST-TRAUMATIC COMPLETE URETHRAL RUPTURE: DEFERRED URGENT URETHRAL SUTURE OR DELAYED REPAIR?

2007 ◽  
Vol 6 (2) ◽  
pp. 185
Author(s):  
M. Sfaxi ◽  
A. Bouzouita ◽  
M.R. Ben Slama ◽  
R. El Attat ◽  
M. Chebil
Keyword(s):  
Surgical Treatment ◽  
Delayed Repair ◽  
Post Traumatic ◽  
Urethral Rupture

Bilateral Optic Canal Meningiomas

Neurosurgery ◽  
1978 ◽  
Vol 3 (1) ◽  
pp. 9-15 ◽  
Author(s):  
Jonathan D. Trobe ◽  
Joel S. Glaser ◽  
Judith D. Post ◽  
Larry K. Page
Keyword(s):  
Surgical Treatment ◽  
Visual Loss ◽  
Correct Diagnosis ◽  
Clinical Suspicion ◽  
Optic Canal ◽  
The Future ◽  
Planum Sphenoidale ◽  
Radiological Studies

Abstract In the case presented, bilateral optic canal meningiomas produced binocular visual loss. Correct diagnosis was delayed because of inadequate and misinterpreted radiological studies. Careful radiological and surgical examination of the planum sphenoidale later suggested this as the source of both canalicular masses. The pertinent aspects of this case are reviewed in relation to information from similar cases reported previously. In the future, increased clinical suspicion and more accurate neuroradiological studies should improve the detection and afford earlier surgical treatment of meningiomas of the optic canal.

scholarly journals The use of locking plates in complex midfoot fractures

2012 ◽  
Vol 94 (8) ◽  
pp. 593-596 ◽  
Author(s):  
E Bayley ◽  
N Duncan ◽  
A Taylor
Keyword(s):  
Articular Surface ◽  
Open Reduction Internal Fixation ◽  
Locking Plates ◽  
Lateral Column ◽  
Improved Outcomes ◽  
Fracture Dislocations ◽  
Angle Stable ◽  
Post Traumatic ◽  
Neurological Injuries

INTRODUCTION Complex fracture dislocations of the midfoot are uncommon. Improved outcomes have been demonstrated where it has been possible to restore and maintain the length and alignment of the medial column as well as the congruity of the articular surfaces. We present our experience with the use of angle-stable locking plates in the stabilisation of complex midfoot fracture dislocations. METHODS Twelve patients were identified on a prospective trauma database between 2003 and 2009. All fractures involved the medial column with four associated fracture subluxations of the lateral column also. Patients underwent open reduction internal fixation (ORIF) with restoration of the medial column axis, reduction of the articular surface congruity and stabilisation with angle-stable locking plates. RESULTS There were no post-operative infections or neurological injuries. Ten of the twelve patients required metalwork removal. There were no implant failures prior to removal of the metalwork. At a mean follow-up of 12.4 months (range: 4–32 months), 11 patients had minimal symptoms of swelling, discomfort or stiffness in the midfoot. This did not restrict their daily activities. One patient developed post-traumatic arthritis and collapse of the medial longitudinal arch. Two patients declined removal of the metalwork. CONCLUSIONS Angle-stable locking plates provide satisfactory stabilisation following ORIF of complex midfoot fracture dislocations. Most patients will require removal of the metalwork. Following removal of metalwork, the majority of patients will maintain the length, alignment and stability of the midfoot.

scholarly journals Peculiarities of Treatment of Lower Extremity Deformities in Children with Systemic Diseases of Loco-Motor System

2003 ◽  
Vol 10 (4) ◽  
pp. 88-89
Author(s):  
Yu A Lapkin ◽  
M P Konyukhov ◽  
Yu A Lapkin ◽  
M P Konyukhov
Keyword(s):  
Surgical Treatment ◽  
Motor System ◽  
Weight Bearing ◽  
Deformity Correction ◽  
Plaster Cast ◽  
Systemic Diseases ◽  
Joint Stability ◽  
Joint Dislocations ◽  
Systemic Nature ◽  
Conservative And Surgical Treatment

The analysis of conservative and surgical treatment results of more than 200 children with systemic diseases of loco-motor system showed that complications and deformity recurrence were mainly caused by the inadequate treatment tactics as well as the use of traditional orthopaedic techniques with no account of the systemic nature of the pathology. The most common mistakes in conservative treatment included the prolonged use of plaster cast, attempts to perform one-step reposition of joint dislocations and underestimation of osteoporosis severity. In surgical treatment the typical mistakes were the attempts to restore the joint function to the detriment of the joint stability and weight bearing function of the extremity, use of tenoligamentocapsulotomy in cases when either correction of bone deformities or the application of flizarov device were indicated. The rate of complications was significantly lower when the deformity correction was followed by additional joint stabilization using transposition of muscles and plasty of ligamentous system.

Sign in / Sign up

Export Citation Format

Share Document