Internal fixation of metal graft for repairing Lisfranc injury:biomechanical evaluation in 18 cases / 中国组织工程研究

ABSTRACT

BACKGROUND:Lisfranc injury is rarely seen in clinical practice, with a low incidence and a high misdiagnosis rate. At present, open reduction and internal fixation is the major treatment, but there is little evidence available on the long-term fol ow-up fol owing injury and foot motor functions fol owing surgery. OBJECTIVE:To evaluate the change of foot functions after metal graft internal fixation in patients with Lisfranc injury. METHODS:Eighteen patients with Lisfranc injury were treated with internal fixation of metal grafts, such as Kirschner wire, screws and steel plate. At 6-8 weeks postoperatively, patients began to walk with crutches. After 1 year fol ow-up, the Footscan balance system and AOFAS scores were applied to evaluate the foot stability and function of patients. RESULTS AND CONCLUSION:After 1 year of internal fixation, al bone fractures were healed, the peak pressure of affected foot in the fourth metatarsal (M4) and the fifth metatarsal (M5) was significantly increased (P<0.05), and the impulse in the fifth metatarsal (M5) and mid-foot bottom (MID) was higher than the contralateral side (P<0.05). The AOFAS score of affected foot was 87.26 ± 21.13 points, the rate of excellent and good efficacy accounted for 88.9%. Internal fixation can rebuild Lisfranc complex stability, the body weight is transferred from the inside to the outside in the front foot, and the remaining pressure did not change significantly, thus the foot function is recovered satisfactorily.