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Outcome after anatomic reduction and transfixation with Kirschner wires of Lisfranc joint injuries

  • Dimitrios S. Korres
  • Ioannis P. PsicharisEmail author
  • Nikolaos Gandaifis
  • Elias C. Papadopoulos
  • Aristides B. Zoubos
  • Konstantinos Nikolopoulos
Original Article

Abstract

Injuries to the tarsometatarsal (Lisfranc) joint are uncommon, and the results of treatment are often unsatisfactory. Open reduction and internal fixation has been recommended as the treatment of choice for most unstable injuries. In the present study, we reviewed 16 patients who underwent closed or open reduction and Kirschner-wire transfixation of a Lisfranc injury in an 11-year period. Mean follow-up was 44 (range, 12–108) months. Average American Orthopaedic Foot and Ankle Society (AOFAS) midfoot score was 78 (range, 45–100) points. Eight patients (50%) developed posttraumatic arthritis of the tarsometatarsal joints. The major cause was nonanatomical reduction, whereas patients with purely ligamentous injury showed a trend toward poorer postoperative outcome. On the basis of our study, open anatomical reduction of fracture-dislocations of the Lisfranc joint and Kirschner-wire transfixation leads to the best long-term outcome.

Keywords

Lisfranc joint Fracture Dislocation Internal fixation 

Résumé

Les traumatismes des articulations tarso-métatarsiennes (Articulation de Lisfranc) ne sont pas courantes et les résultats du traitement sont souvent peu satisfaisantes. La réduction à ciel ouvert et la stabilisation par ostéosynthèse interne constituent le traitement de choix pour la plupart des fractures instables. Nous avons revu 16 patients traités par réduction ouverte ou fermée et stabilisés par embrochage de l'articulation de Lisfranc, et ce durant une période de onze années. Le recul moyen est de quarante quatre mois (extrêmes 12 et 108 mois). Le résultat moyen selon le score AOFAS est de 78 points (extrêmes 45 et 100 points). Huit patients ont présenté une arthrose post-traumatique de l'articulation de Lisfranc. La cause principale en est une réduction non anatomique, alors que les patients ayant seulement un traumatisme ligamentaire avaient tendance à des résultats post-opératoires de moins bonne qualité. Sur la base de notre étude, la réduction anatomique à ciel ouvert des fractures-luxation de l'articulation de Lisfranc, suivie d'un embrochage apparaît comme le meilleur résultat à long terme.

Mots clés

Articulation de Lisfranc Fracture Luxation Fixation interne 

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Copyright information

© Springer-Verlag 2003

Authors and Affiliations

  • Dimitrios S. Korres
    • 1
  • Ioannis P. Psicharis
    • 1
    • 2
    Email author
  • Nikolaos Gandaifis
    • 1
  • Elias C. Papadopoulos
    • 1
  • Aristides B. Zoubos
    • 1
  • Konstantinos Nikolopoulos
    • 1
  1. 1.First Orthopaedic DepartmentUniversity of AthensAthensGreece
  2. 2.7 Ag Elenis st. AthensGreece

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