Chinese Journal of Tissue Engineering Research ›› 2015, Vol. 19 ›› Issue (11): 1732-1738.doi: 10.3969/j.issn.2095-4344.2015.11.018

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Internal fixation implants for Lisfranc ligament injury based on anatomical location

Guo Hong-liang1, Yilihamu Tuoheti1, Li Shan-zhu2, Yu Guang-rong2, Wang Zhi-zhou1, Gan Zi-ming3   

  1. 1Department of Orthopedics, the Second Affiliated Hospital of Xinjiang Medical University, Urumqi 830063, Xinjiang Uygur Autonomous Region, China; 2Department of Orthopedics, Tongji Hospital, Tongji University, Shanghai 200065, China; 3Division of Anatomy, Xinjiang Medical University, Urumqi 830000, Xinjiang Uygur Autonomous Region, China
  • Revised:2014-12-17 Online:2015-03-12 Published:2015-03-12
  • Contact: Yilihamu Tuoheti, Chief physician, Department of Orthopedics, the Second Affiliated Hospital of Xinjiang Medical University, Urumqi 830063, Xinjiang Uygur Autonomous Region, China
  • About author:Guo Hong-liang, Studying for master’s degree, Department of Orthopedics, the Second Affiliated Hospital of Xinjiang Medical University, Urumqi 820063, Xinjiang Uygur Autonomous Region, China
  • Supported by:

    the Technological Support Project for Xinjiang Uygur Autonomous Region, the Science and Technology Project of Xinjiang Uygur Autonomous Region, No. 2013911112

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Abstract:

BACKGROUND: The Lisfranc joint has a complex structure with bony joint surfaces overlapped on the conventional X-ray film, which is diagnosed difficultly. There are less anatomical studies on the Lisfranc ligament, which leads to no accurate anatomical evidence for the repair of Lisfranc ligament injury.

OBJECTIVE: To measure the stable structure of Lisfranc ligament at static state so as to provide anatomical evidence for clinical repair of Lisfranc ligament injury.
METHODS: (1) Eighteen adult corpse specimens were dissected to observe the morphology of Lisfranc ligament and measure relevant parameters as anatomical group. In the anatomical group, the traveling trend and bony landmarks were confirmed. Another 14 adult corpse specimens were taken as experimental group to fix the Lisfranc ligament using a guide pin and detect the corresponding Lisfranc ligament data based on the above-mentioned parameters. Measured angle and length from the entocuneiform to the second metatarsal base were compared between the two groups. (2) Eight patients with clinically confirmed Lisfranc injury were subject to open reduction and internal fixation surgery based on anatomical parameters and positioning method. Patients were followed up for 8-14 months, and AOFAS Ankle Hindfoot Scale was used for functional evaluation.
RESULTS AND CONCLUSION: The Lisfranc ligament had two bundles. There was no difference in the morphological measurement between the anatomical and experimental groups (P > 0.05). “Lisfranc channel” was proposed by the authors, which was defined as: the length, width and height from the entocuneiform (with no ligament) to the second metatarsal base were (31.65±2.23) mm, (8.16±1.37) mm, (1.69±0.21) mm, respectively, and the angles with the proximal entocuneiform and plantar side of the proximal entocuneiform were (45.83±6.84)° and (65.11±4.69)°, respectively. Hematoxylin-eosin staining showed the histological characteristics of the Lisfranc ligament with the surrounding tissues and there was a four-layer structure: Lisfranc tendons, tide lines, mineralized fibrocartilage and bone. (2) After treatment, the AOFAS Ankle Hindfoot Scale scores were improved to (80.30±4.85) points in the eight patients. Morphological parameters of Lisfranc joint and ligament obtained from anatomical experiments provide anatomical evidence for the repair of Lisfranc injury, and avoid blinded internal fixation that can cause the damage to the starting point of the Lisfranc ligament and impact the restorative effects on Lisfranc injury.


中国组织工程研究杂志出版内容重点：组织构建；骨细胞；软骨细胞；细胞培养；成纤维细胞；血管内皮细胞；骨质疏松；组织工程


全文链接：

Key words: Ligaments, Autopsy, Internal Fixators, Follow-Up Studies

CLC Number: