ABSTRACT
Objective To evaluate distractor-assisted reduction for Lisfranc injury complicated with compressive fracture of lateral foot column.Methods A retrospective study was conducted of the 18 patients who had been treated surgically at Department of Foot and Ankle Surgery,Zhengzhou Orthopaedics Hospital between May 2014 and March 2017 for Lisfranc injury complicated with compressive fracture of lateral foot column.They were 10 males and 8 females,with an average age of 38.4 years (from 25 to 65 years).The injury involved the right foot in 11 cases and the left foot in 7.Their concomitant injuries were 12 compressive cuboid fractures and 6 compressive fractures of the calcaneal anterior process.According to the Chiodo-Myerson classification,there were 13 cases of three-column injury,3 ones of middle-lateral column injury and 2 ones of medial-lateral column injury.All the injuries were closed.After the condition of foot soft tissues permitted,open reduction assisted by a distractor and internal fixation with a mini locking plate was performed.Functional outcomes were assessed according to the American Orthopaedic Foot and Ankle Society (AOFAS) hindfoot-ankle scores and visual analogue scale (VAS) at the final follow-ups and complications during follow-up.Results The 18 patients were followed up for one to 4 years (average,2 years).Their AOFAS hindfoot-ankle scores ranged from 55 to 96 points (average,80.4 points);their VAS ranged from 0 to 6 points (average,1.5 points).Radiographic evidence of degeneration was noted in 10 patients.Of them,2 reported persistent pain which was cured by arthrodesis after conservative therapy failed and one presented with symptoms of injury to sural and cutaneous nerves which disappeared after oral administration of neurotrophic drugs for half a year.No such complication as skin necrosis,infection or implant failure occurred in other patients.Conclusion Open distractor-assisted reduction and internal fixation of lateral foot column with a mini locking plate,combined with bone graft if necessary,is an effective treatment for Lisfranc injury complicated with compressive fracture of lateral foot column,because it can effectively restore the alignment of lateral column and result in satisfactory therapeutic effects.
ABSTRACT
Objective To evaluate surgical treatment for Lisfranc injury with cuboid compressive fracture.Methods Totally 19 cases of Lisfranc injury with cuboid compressive fracture were treated at Department of Orthopaedic Surgery,Shanghai Sixth People's Hospital from June 2010 to June 2016.They were 12 men and 7 women,with an average age of 41.2 years (from 20 to 70 years).Selective open reduction and internal fixation was not applied for all the cases until their soft tissue condition was improved.American Orthopaedic Foot and Ankle Society (AOFAS) and visual analogue scale (VAS) were used to evaluate the outcomes.Results Of this cohort,18 cases were followed up for an average of 4 years (from 1 to 7 years).Their postoperative AOFAS midfoot scores ranged from 56 to 97 points,averaging 81.9 points;their VAS scores ranged from 0 to 7 points,averaging 1.7 points.Two patients reported persistent pain due to traumatic midfoot arthritis which was cured by arthrodesis after conservative therapy failed.No such complications as nonunion,malunion or implant failure occurred in the other patients.Conclusion Open reduction and internal fixation combined with bone graft and external fixation is an effective treatment for Lisfranc injury with cuboid compressive fracture,because it can restore the alignment of lateral column and achieve rigid stabilization.
ABSTRACT
Fracuture-dislocation of the cuboid is an extremely rere injury compared with fracture-dislocation of other tarsal bones. We report a case of the fracture-dislocation of the cuboid treated by open reduction and internal fixation.