Summary
Between 1991 and 1992 three patients (21-17-27-year-old males) with open fracture-dislocation of the tarsometatarsal joint were managed in our Department. Two of the patients had type II injuries and the third a type III. There was severe soft tissue damage and therefore, a high risk of infection and necrosis.
The diagnosis was easy in every case. They were all managed surgically 1–3 hours after their appearance at hospital and in any case, during the first 8 hours following the injury. They had debridement and reduction. Fixation was achieved with K-wires.
Postoperatively a short leg cast was applied and antibiotics were given. The cast was maintained for six weeks. Then the K-wires were removed and progressive weight-bearing was allowed. After a follow-up period of 28-43-4o months, only the second patient has complained of mild pain during his military service. All have developed flatfoot.
Résumé
De 1991 à 1992, trois malades ont été traités dans notre service pour une fracture-luxation ouverte de l'articulation de Lisfranc. Deux malades présentaient un traumatisme du type II et le troisième du type III.
Tous les malades avaient de graves lésions des parties molles et avaient de grands risques d'infection et de nécrose.
Le diagnostic a été facilement posé après l'examen radiologique. Les trois malades ont été opérés entre 1 et 3 heures après l'hospitalisation. Nous avons effectué un débridement puis une réduction maintenue par des broches de Kirschner.
Après l'intervention a été mis un plâtre jambier pour six semaines. Après l'ablation des broches les malades ont commencé à marcher avec appui progressif.
Après un follow-up respectivement de 28, 43 et 40 mois, seul le deuxième malade s'est plaint de douleurs pendant son service militaire. Les trois malades, par contre, ont présenté un pied plat.
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Efstathopoulos, N., Papachristou, G., Agoropoulos, Z. et al. Open fractures-dislocations of the tarsometatarsal (Lisfranc) joints Report of three cases. Eur J Orthop Surg Traumatol 7, 41–43 (1997). https://doi.org/10.1007/BF00578833
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DOI: https://doi.org/10.1007/BF00578833