![]() A 5–6 cm dorsal longitudinal incision was made over the interval between the 1 st and 2 nd TMT joints. The surgical technique described by Henning et al. The space between the medial cuneiform and second metatarsal base should be 2 mm, or there was >15 of persistent talo-first metatarsal angulation. On the lateral X-ray, a metatarsal should not be located more dorsal than its corresponding tarsal bone. In the radiological examination, a normal result was defined as the medial edge of the second metatarsal parallel to the medial border of the second cuneiform on both the anteroposterior and oblique views of the foot. The alignment of Lisfranc reduction was evaluated on weight-bearing anteroposterior, lateral, and oblique radiographs, and the reduction was classified into three categories anatomic, nearly anatomic, and non-anatomic. Patients in Group 1 were treated with fixation with PPA (arthrodesis of the first two TMT joints) and those in Group 2 with fixation with closed reduction and percutaneous internal fixation. The fractures were classified according to the Myerson et al. The pre-operative X-ray and computed tomography (CT) scans were evaluated. There are also three subcategories of pain (0–40), function (0–45), and alignment (0–15). The AOFAS is based on a scale from 0 to 100, where 0 indicates the worst results and 100 the best results. Those who agreed to participate were invited to complete the American orthopaedic foot and ankle society score for the midfoot (AOFAS), and a record was made of the general medical history and physical examination findings. All patients were contacted by phone, e-mail, or message to participate in the study. ![]() After the application of the exclusion criteria, 45 patients were found to be eligible for the study. The exclusion criteria were defined as involvement of third, fourth, or fifth metatarsals, concomitant fracture in the lower extremity, the presence of inflammatory arthritis, a Lisfranc injury other than Myerson Type B, and those treated with ORIF. The patients included in the study were those aged 18–60 years with a Lisfranc injury classified as Myerson Type B treated with PPA or CLIF, and a follow-up period of at least 12 months. A retrospective analysis was made of the orthopedic operative records to identify patients who underwent surgery for acute Lisfranc injury between 20. The purpose of this study was to compare the clinical and radiological outcomes of patients treated with PPA or closed reduction and internal fixation (CLIF) for an acute Lisfranc injury.Īpproval for this study was granted by the Hospital Internal Ethics Committee. In recent years, primary partial arthrodesis (PPA) has been used in acute Lisfranc injuries and good outcomes have been observed. Historically, partial arthrodesis has been suggested as a salvage procedure after failed conservative or surgical treatment of Lisfranc injury. However, extended soft-tissue dissection and the association of this technique with a high risk of complications due to dissection led to advancements in percutaneous techniques for the treatment of Lisfranc injuries. Open reduction and internal fixation (ORIF) is a well-established technique in the treatment of Lisfranc injuries. Good clinical results are correlated with anatomic reduction of the TMT joint. The main aim of the treatment is the anatomic reduction of the TMT joint. There is a wide spectrum of treatment methods, ranging from conservative treatment with a plaster cast, percutaneous K-wire, open reduction, and internal fixation with a trans-articular screw or a dorsal bridging plate or primary arthrodesis. ![]() The restoration of the TMT anatomy and maintenance of normal tarsal congruity is the mainstay of the treatment to reduce the risk of arthritis and achieve good results. These traumas vary from pure ligamentous injuries to severely comminuted TMT fracture-dislocation. The mechanism of the injury is axial loading of the hyper-plantarflexed foot. The scale of a Lisfranc injury varies from low-energy sports injuries to high-energy crush injuries. Lisfranc ligament injuries result in disruption of the foot’s transverse arch, leading to pain and residual deformity of the foot. The Lisfranc ligament is the strongest ligament of the foot, which extends from the lateral aspect of the medial cuneiform to the medial aspect of the second metatarsal base. A disruption of the osseoligamentous complex of the tarsometatarsal (TMT) joint is defined as a Lisfranc injury.
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