Anatomical Pathology of Subtle Lisfranc Injury

The extent and patterns of Lisfranc joint complex disruption in subtle Lisfranc injuries have not been well clarified. We reviewed the direct intraoperative findings for 87 patients, examined computed tomography images that had been obtained preoperatively for 73 of the patients, and classified the...

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Bibliographic Details
Published in:Scientific reports 2019-10, Vol.9 (1), p.14831-6, Article 14831
Main Authors: Haraguchi, Naoki, Ota, Koki, Ozeki, Takuma, Nishizaka, Shingo
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Aged, 80 and over
Computed tomography
Female
Fractures, Bone - classification
Fractures, Bone - pathology
Humans
Joint and ligament injuries
Joint Instability - classification
Joint Instability - pathology
Male
Metatarsal Bones - pathology
Metatarsus
Middle Aged
Tarsal Bones - pathology
Tarsal Joints - injuries
Tarsal Joints - surgery
Tomography, X-Ray Computed
Young Adult
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Summary:The extent and patterns of Lisfranc joint complex disruption in subtle Lisfranc injuries have not been well clarified. We reviewed the direct intraoperative findings for 87 patients, examined computed tomography images that had been obtained preoperatively for 73 of the patients, and classified the injuries according to the Kaar  et al. criteria as the transverse type (instability between the first cuneiform [C1] and the second metatarsal [M2] and between the second cuneiform [C2] and M2) or longitudinal type (instability between C1 and M2 and between C1 and C2). Our patients' injuries were classified as follows: longitudinal type (38%), transverse type (30%), transverse type and first tarsometatarsal (TMT) joint injury (20%), longitudinal type plus transverse type (7%), longitudinal type and first TMT joint injury (3%), and longitudinal type, transverse type, and first TMT joint injury (2%). In 11 patients, the longitudinal injury extended into the naviculo-first cuneiform joint. In 41 (56%) of the 73 patients for whom CT images were obtained, 1 or more fractures (not counting small avulsion fragments between C1 and M2) were found. Orthopedic surgeons should be aware of the various injury patterns possible in cases of subtle Lisfranc injury.
ISSN:2045-2322
2045-2322
DOI:10.1038/s41598-019-51358-8