Internal fixation of metal graft for repairing Lisfranc injury: biomechanical evaluation in 18 cases

doi:10.3969/j.issn.2095-4344.2014.35.021

Abstract

Abstract:

BACKGROUND: Lisfranc injury is rarely seen in clinical practice, with a low incidence and a high misdiagnosis rate. At present, open reduction and internal fixation is the major treatment, but there is little evidence available on the long-term follow-up following injury and foot motor functions following surgery.
OBJECTIVE: To evaluate the change of foot functions after metal graft internal fixation in patients with Lisfranc injury.
METHODS: Eighteen patients with Lisfranc injury were treated with internal fixation of metal grafts, such as Kirschner wire, screws and steel plate. At 6-8 weeks postoperatively, patients began to walk with crutches. After 1 year follow-up, the Footscan balance system and AOFAS scores were applied to evaluate the foot stability and function of patients.
RESULTS AND CONCLUSION: After 1 year of internal fixation, all bone fractures were healed, the peak pressure of affected foot in the fourth metatarsal (M4) and the fifth metatarsal (M5) was significantly increased (P < 0.05), and the impulse in the fifth metatarsal (M5) and mid-foot bottom (MID) was higher than the contralateral side (P < 0.05). The AOFAS score of affected foot was 87.26 ± 21.13 points, the rate of excellent and good efficacy accounted for 88.9%. Internal fixation can rebuild Lisfranc complex stability, the body weight is transferred from the inside to the outside in the front foot, and the remaining pressure did not change significantly, thus the foot function is recovered satisfactorily.

中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程

全文链接：

Key words: internal fixators, biomechanics, prostheses and implants

CLC Number:

R318

Hou Yan-jie, Yan Bin, Han Ya-jun, Yilihamu•tuoheti . Internal fixation of metal graft for repairing Lisfranc injury: biomechanical evaluation in 18 cases[J]. Chinese Journal of Tissue Engineering Research, 2014, 18(35): 5693-5698.

Figures/Tables 2

References

[1] van Rijn J, Dorleijn DM, Boetes B,et al. Missing the Lisfranc fracture: a case report and review of the literature. J Foot Ankle Surg. 2012;51(2):270-274.
[2] 唐康来,许建中. Lisfranc关节损伤诊断与处理原则[J].中华创伤杂志,2010,26(12):1160-1163.
[3] Myerson MS,Fisher RT, Burgess AR,et al. Fracture dislocations of the tarsometatarsal joints：end resuhs correlated with pathology and 1 realnlent. Foot Ankle. 1986; 6(5):225-242．
[4] Kitaoka H,Alexander I,Adelaar R,et al.Clinical rating systems for the ankle-hind-fot,midfot,hallux and lesser toes. Foot Ankle Clins. 1994;15(7):349-353.
[5] DeOrio M,Erickson M,Usuelli FG, et al.Lisfranc injuries in sport. Foot Ankle Clin. 2009;14(2):169-186.
[6] Castro M, Melão L, Canella C, et al. Lisfranc joint ligamentous complex: MRI with anatomic correlation in cadavers. AJR Am J Roentgenol. 2010;195(6):447-455.
[7] 王亦璁.骨与关节损伤[M].3版.北京:人民卫生出版社,2004: 1152.
[8] Miswan MF,Singh VA,Yasin NF.Outcome of surgically treated Lisfranc injury:a review of 34 cases.Ulus Travma Acil Cerrahi Derg. 2011;17(6):504-508.
[9] Mayich DJ,Mayich MS.Daniels TR. Effective detection and management of Iow-velodty Lisfranc injurles in the emergency setting:principles for a subtIe and commonly nlissed entity.Can Fam Physician. 2012;58(11):1199-1204.
[10] Macmahon PI,Dheer S,Raikm SM,et al. MRI of injuries to the first interosseous cuneometatarsal(Lisfranc)ligament. Skeletal Radiol. 2009;38(3):255-260.
[11] Gupta RT,Wadhwa RP,Iearch TJ,et al. Lisfranc injury:imaging findings for this important but often-missed diagnosis. Curr Probl Diagn Radiol. 2008;37(3):115-126.
[12] 肖松,黄剑虹,陈高峰.切开复位内固定治疗跗跖关节损伤17例报告[J].骨科,2011,48(4):184-186
[13] Watson TS, Shurnas PS, Denker J. Treatment of Lisfranc joint injury: current concepts. J Am Acad Orthop Surg. 2010;18(12): 718-728.
[14] Panchbhavi VK.Orentation of the “Lisfranc screw”. J Orthop Trauma. 2012;26(11):e221-e224.
[15] 杨兵,江庭彪,韦家宁. 手术治疗Lisfranc骨折脱位临床体会[J]. 实用骨科杂志,2013,19(1):30-32.
[16] Wright A,Gerhart AE.Lisfranc fracturesr. Adv Emerg Nurs J. 2009;31(4):269-276.
[17] Chaney DM.The Lisfranc joint.Clin Podiatr Med Surg. 2010; 27(4):547-560.
[18] Lundeen G,Sara S.Technique tip:the use of a washer and suture endobutton in revision lisfrane fixation.Foot Ankle Int.2009;30(7):713-715.
[19] Panehbhavi VK,Vallumpalli S,Yang J,et al. Screw fixation compaMl with suture-button fixation of isolated Lisfranc ligament injuries.J Bone Joint Surg(Am). 2009;91(5): 1143-1148.
[20] Sands AK,Grose A.Lisfranc injuries.Injury. 2004;35(Suppl 2):71-76.
[21] 张云峰,段洪,周立新,等.切开复位内固定治疗早期Lisfranc关节损伤[J].中华创伤杂志,2011,27(4):346-348.
[22] 杨光诗,徐林,林国栋,等. 切开复位内固定治疗Lisfranc损伤的疗效分析[J].中华创伤骨科杂志,2012,14(7):643-644.
[23] Karaindros K, Arealis G, Papanikolaou A, et al. Irreducible Lisfranc dislocation due to the interposition of the tibialis anterior tendon: case report and literature review. Foot Ankle Surg. 2010;16(3):68-71.
[24] Nunley JA,Vertullo CJ.Classification,investigation,and management of midfoot sprains:Lisfrane injuries in the athlete. Am J Sports Med. 2002;30(6):871-878.
[25] Eleftheriou KI, Rosenfeld PF, Calder JD.Lisfranc injuries: an update. Knee Surg Sports Traumatol Arthrosc. 2013;21(6): 1434-46.
[26] Mittlmeier T, Beck M. Injuries of the midfoot. Chirurg. 2011; 82(2):169-186.
[27] Henning JA,Jones CB,Sietsema DL,et al.Open reduction internaifixation versus primary arthrodesis for Lisfranc injuries: a prospective randomized study.Foot Ankie Int. 2009;30(10): 913-922.
[28] Young CR. The F-SCAN system of foot pressure analysis. Clin Podiatr Med Surg. 1993;10(3): 455-461.
[29] 姚琦,陈迎春,张亘瑷,等.空心螺钉三柱重建技术治疗Lisfranc关节损伤[J].中华创伤杂志,2011,27(10):893-895.
[30] Coetzee JC,Ly TV. Treatment of primarily ligamentous Lisfranc joint injuries:primary arthrodesis compmecl with open reduction and internal fixation.Surgical technique.J Bone Joint Surg Am. 2007;89(Suppl 2 Part 1):122-127.
[31] Joveniaux P, Ohl X, Harisboure A, et al. Distal tibia fractures: management and complications of 101 cases. Int Orthop. 2010; 34(4): 583-588.
[32] Tadros AM, Al-Hussona M. Bilateral tarsometatarsal fracture-dislocations: a missed work-related injury. Singapore Med J. 2008;49(9):234-235.