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The role of reduction and internal fixation of Lisfranc fracture–dislocations: a systematic review of the literature

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Abstract

A systematic review of the literature was performed in order to evaluate the role of reduction and internal fixation in the management of Lisfranc joint fracture–dislocations. Articles were extracted from the Pubmed database and the retrieved reports were included in the study only if pre-specified eligibility criteria were fulfilled. Eleven articles were eligible for the final analysis, reporting data for the management of 257 patients. Injuries of the first three metatarsal rays were treated by closed reduction and internal fixation with screws in 16.3% of the patients, open reduction and internal fixation with screws in 66.5% and open reduction and internal fixation with Kirschner wires (K-wires) in 17.1% of the patients. The preferred method for the stabilisation of the fourth and fifth metatarsal rays was K-wires. Screw-related complications were common and were reported in 16.1% of the cases. The mean American Orthopaedic Foot and Ankle Society midfoot score was 78.1 points. Post-traumatic radiographic arthritis was reported in 49.6% of the patients, but only in 7.8% of them it was severe enough to warrant an arthrodesis. We conclude that open reduction and internal fixation of the first three metatarsal rays with screws is a reliable method for the management of Lisfranc injuries. This can be complemented by K-wires application in the fourth and fifth metatarsal rays if needed.

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References

  1. Aitken AP, Poulson D (1963) Dislocations of the tarsometatarsal joint. J Bone Joint Surg Am 45-A:246–260

    Google Scholar 

  2. Arntz CT, Veith RG, Hansen ST Jr (1988) Fractures and fracture-dislocations of the tarsometatarsal joint. J Bone Joint Surg Am 70:173–181

    CAS  PubMed  Google Scholar 

  3. Aronow MS (2006) Treatment of the missed Lisfranc injury. Foot Ankle Clin 11:127–142

    Article  PubMed  Google Scholar 

  4. Cassebaum WH (1963) Lisfranc fracture-dislocations. Clin Orthop Relat Res 30:116–129

    Article  CAS  PubMed  Google Scholar 

  5. Coetzee JC (2008) Making sense of Lisfranc injuries. Foot Ankle Clin 13:695–704

    Article  PubMed  Google Scholar 

  6. Desmond EA, Chou LB (2006) Current concepts review: Lisfranc injuries. Foot Ankle Int 27:653–660

    PubMed  Google Scholar 

  7. English TA (1964) Dislocations of the metatarsal bone and adjacent toe. J Bone Joint Surg Br 46:700–704

    CAS  PubMed  Google Scholar 

  8. Goossens M, De Stoop N (1983) Lisfranc's fracture-dislocations: etiology, radiology, and results of treatment. A review of 20 cases. Clin Orthop Relat Res 176:154–162

    Google Scholar 

  9. Haapamaki V, Kiuru M, Koskinen S (2004) Lisfranc fracture-dislocation in patients with multiple trauma: diagnosis with multidetector computed tomography. Foot Ankle Int 25:614–619

    PubMed  Google Scholar 

  10. Hardcastle PH, Reschauer R, Kutscha-Lissberg E et al (1982) Injuries to the tarsometatarsal joint. Incidence, classification and treatment. J Bone Joint Surg Br 64:349–356

    CAS  PubMed  Google Scholar 

  11. Henning JA, Jones CB, Sietsema DL et al (2009) Open reduction internal fixation versus primary arthrodesis for Lisfranc injuries: a prospective randomized study. Foot Ankle Int 30:913–922

    Article  PubMed  Google Scholar 

  12. Hunt SA, Ropiak C, Tejwani NC (2006) Lisfranc joint injuries: diagnosis and treatment. Am J Orthop 35:376–385

    PubMed  Google Scholar 

  13. Johnson JE, Johnson KA (1986) Dowel arthrodesis for degenerative arthritis of the tarsometatarsal (Lisfranc) joints. Foot Ankle 6:243–253

    CAS  PubMed  Google Scholar 

  14. Kenzora JE, Edwards CC, Browner BD et al (1981) Acute management of major trauma involving the foot and ankle with Hoffmann external fixation. Foot Ankle 1:348–361

    CAS  PubMed  Google Scholar 

  15. Kitaoka HB, Alexander IJ, Adelaar RS et al (1994) Clinical rating systems for the ankle-hindfoot, midfoot, hallux, and lesser toes. Foot Ankle Int 15:349–353

    CAS  PubMed  Google Scholar 

  16. Komenda GA, Myerson MS, Biddinger KR (1996) Results of arthrodesis of the tarsometatarsal joints after traumatic injury. J Bone Joint Surg Am 78:1665–1676

    CAS  PubMed  Google Scholar 

  17. Kuo RS, Tejwani NC, Digiovanni CW et al (2000) Outcome after open reduction and internal fixation of Lisfranc joint injuries. J Bone Joint Surg Am 82-A:1609–1618

    CAS  PubMed  Google Scholar 

  18. Lee CA, Birkedal JP, Dickerson EA et al (2004) Stabilization of Lisfranc joint injuries: a biomechanical study. Foot Ankle Int 25:365–370

    PubMed  Google Scholar 

  19. Lenczner EM, Waddell JP, Graham JD (1974) Tarsal-metatarsal (Lisfranc) dislocation. J Trauma 14:1012–1020

    Article  CAS  PubMed  Google Scholar 

  20. Loveday D, Robinson A (2008) Lisfranc injuries. Br J Hosp Med (Lond) 69:399–402

    Google Scholar 

  21. Ly TV, Coetzee JC (2006) Treatment of primarily ligamentous Lisfranc joint injuries: primary arthrodesis compared with open reduction and internal fixation. A prospective, randomized study. J Bone Joint Surg Am 88:514–520

    Article  PubMed  Google Scholar 

  22. Martin DP, Engelberg R, Agel J et al (1996) Development of a musculoskeletal extremity health status instrument: the Musculoskeletal Function Assessment instrument. J Orthop Res 14:173–181

    Article  CAS  PubMed  Google Scholar 

  23. Mulier T, Reynders P, Dereymaeker G et al (2002) Severe Lisfrancs injuries: primary arthrodesis or ORIF? Foot Ankle Int 23:902–905

    PubMed  Google Scholar 

  24. Mulier T, Reynders P, Sioen W et al (1997) The treatment of Lisfranc injuries. Acta Orthop Belg 63:82–90

    CAS  PubMed  Google Scholar 

  25. Myerson MS (1999) The diagnosis and treatment of injury to the tarsometatarsal joint complex. J Bone Joint Surg Br 81:756–763

    Article  CAS  PubMed  Google Scholar 

  26. Myerson MS, Cerrato R (2009) Current management of tarsometatarsal injuries in the athlete. Instr Course Lect 58:583–594

    PubMed  Google Scholar 

  27. Myerson MS, Fisher RT, Burgess AR et al (1986) Fracture dislocations of the tarsometatarsal joints: end results correlated with pathology and treatment. Foot Ankle 6:225–242

    CAS  PubMed  Google Scholar 

  28. Ouzounian TJ, Shereff MJ (1989) In vitro determination of midfoot motion. Foot Ankle 10:140–146

    CAS  PubMed  Google Scholar 

  29. Papadokostakis G, Papakostidis C, Dimitriou R et al (2005) The role and efficacy of retrograding nailing for the treatment of diaphyseal and distal femoral fractures: a systematic review of the literature. Injury 36:813–822

    Article  CAS  PubMed  Google Scholar 

  30. Perez Blanco R, Rodriguez Merchan C, Canosa Sevillano R et al (1988) Tarsometatarsal fractures and dislocations. J Orthop Trauma 2:188–194

    Article  CAS  PubMed  Google Scholar 

  31. Perugia D, Basile A, Battaglia A et al (2003) Fracture dislocations of Lisfranc's joint treated with closed reduction and percutaneous fixation. Int Orthop 27:30–35

    PubMed  Google Scholar 

  32. Quenu E, Küss G (1909) Etude sur les luxations du metatarse (luxations metatarsotarsiennes) du diastasis entre le 1er et le 2e metatarsien. Rev Chir 39:1093–1134

    Google Scholar 

  33. Rajapakse B, Edwards A, Hong T (2006) A single surgeon's experience of treatment of Lisfranc joint injuries. Injury 37:914–921

    Article  PubMed  Google Scholar 

  34. Rammelt S, Schneiders W, Schikore H et al (2008) Primary open reduction and fixation compared with delayed corrective arthrodesis in the treatment of tarsometatarsal (Lisfranc) fracture dislocation. J Bone Joint Surg Br 90:1499–1506

    Article  CAS  PubMed  Google Scholar 

  35. Richter M, Wippermann B, Krettek C et al (2001) Fractures and fracture dislocations of the midfoot: occurrence, causes and long-term results. Foot Ankle Int 22:392–398

    CAS  PubMed  Google Scholar 

  36. Sangeorzan BJ, Veith RG, Hansen ST Jr (1990) Salvage of Lisfranc's tarsometatarsal joint by arthrodesis. Foot Ankle 10:193–200

    CAS  PubMed  Google Scholar 

  37. Saxena A (2005) Bioabsorbable screws for reduction of Lisfranc's diastasis in athletes. J Foot Ankle Surg 44:445–449

    Article  PubMed  Google Scholar 

  38. Tan YH, Chin TW, Mitra AK et al (1995) Tarsometatarsal (Lisfranc's) injuries—results of open reduction and internal fixation. Ann Acad Med Singapore 24:816–819

    CAS  PubMed  Google Scholar 

  39. Teng AL, Pinzur MS, Lomasney L et al (2002) Functional outcome following anatomic restoration of tarsal-metatarsal fracture dislocation. Foot Ankle Int 23:922–926

    PubMed  Google Scholar 

  40. Thompson MC, Mormino MA (2003) Injury to the tarsometatarsal joint complex. J Am Acad Orthop Surg 11:260–267

    PubMed  Google Scholar 

  41. Thordarson DB, Hurvitz G (2002) PLA screw fixation of Lisfranc injuries. Foot Ankle Int 23:1003–1007

    PubMed  Google Scholar 

  42. Vuori JP, Aro HT (1993) Lisfranc joint injuries: trauma mechanisms and associated injuries. J Trauma 35:40–45

    Article  CAS  PubMed  Google Scholar 

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The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Academic Department of Trauma & Orthopaedic Surgery, University of Leeds, Leeds General Infirmary, Clarendon Wing, Great George St, LS1 3EX, Leeds, UK

    Panagiotis Stavlas, Fragiskos N. Xypnitos & Peter V. Giannoudis

  2. Department of Orthopaedic Surgery, University of Louisville, Louisville, KY, USA

    Craig S. Roberts

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  1. Panagiotis Stavlas
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  2. Craig S. Roberts
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  3. Fragiskos N. Xypnitos
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  4. Peter V. Giannoudis
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Correspondence to Peter V. Giannoudis.

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Stavlas, P., Roberts, C.S., Xypnitos, F.N. et al. The role of reduction and internal fixation of Lisfranc fracture–dislocations: a systematic review of the literature. International Orthopaedics (SICOT) 34, 1083–1091 (2010). https://doi.org/10.1007/s00264-010-1101-x

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