Clinical efficacy of selective tarsometatarsal arthrodesis for old Lisfranc injuries_West China Medical Journal

Authors：

DENG Wei ¹ , LI Zongwei ² , WANG Shengtao ¹ , CAI Jieyong ¹ , ZHANG Hanwen ¹ ,  YIN Yong ¹

1. Department of Orthopedics, Pidu District People’s Hospital, the Third Affiliated Hospital of Chengdu Medical College, Chengdu, Sichuan 611730, P. R. China;
2. Department of Foot and Ankle Surgery, Mianyang Orthopaedic Hospital, Mianyang, Sichuan 621000, P. R. China;

Corresponding author：

YIN Yong, Email: piduyinyong@163.com

Keywords：

Old Lisfranc injuries; open reduction; tarsometatarsal arthrodesis

DOI：

10.7507/1002-0179.202207168

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Objective To investigate the clinical efficacy of selective tarsometatarsal arthrodesis for old Lisfranc injury without significant post-traumatic osteoarthritis (PTOA). Methods The clinical data of patients with old Lisfranc injury without significant PTOA who were treated by selective tarsometatarsal arthrodesis at Chengdu Pidu District People’s Hospital between June 2013 and June 2021 were analyzed retrospectively. The improvement of patients’ Visual Analogue Scale (VAS) score, American Orthopedic Foot Ankle Society (AOFAS) midfoot score and Short Form 12 (SF-12) score before surgery and at the final follow-up were compared. Results Seventeen oldLisfranc injury patients (17 feet) without significant PTOA were finally recorded, including 12 males and 5 females. All patients completed the surgery successfully, and the surgical incisions healed smoothly after surgery without complications such as poor incision healing, soft tissue ischemic necrosis, and deep and superficial infections. All patients were followed up for an average of 22.6 months (12 to 36 months). Three months after surgery, follow-up X-ray films showed bony healing of the fused ends in all patients, and the patient satisfaction was 94.1%. Compared with the preoperative scores, VAS score (6.0±0.3 vs. 0.8±0.2), AOFAS score (50.5±1.5 vs. 86.5±0.9), SF-12 physiological score (21.9±0.6 vs. 46.1±0.5) and SF-12 psychological score (31.1±0.8 vs. 47.3±0.7) at the last follow-up improved (P<0.05). Conclusion Selective tarsometatarsal arthrodesis for the old Lisfranc injuries without significant PTOA can restore the midfoot force lines and stability, avoid stiffness after full feet fusion, preserve midfoot function, and improve patient satisfaction.

Citation： DENG Wei, LI Zongwei, WANG Shengtao, CAI Jieyong, ZHANG Hanwen, YIN Yong. Clinical efficacy of selective tarsometatarsal arthrodesis for old Lisfranc injuries. West China Medical Journal, 2022, 37(10): 1487-1492. doi: 10.7507/1002-0179.202207168 Copy

1.	Ponkilainen VT, Laine HJ, Mäenpää HM, et al. Incidence and characteristics of midfoot injuries. Foot Ankle Int, 2019, 40(1): 105-112.
2.	李莹, 李文菁, 孙宁, 等. 陈旧性 Lisfranc 损伤手术治疗的中短期疗效分析. 中华创伤骨科杂志, 2022, 24(1): 19-24.
3.	Sripanich Y, Weinberg MW, Krähenbühl N, et al. Surgical outcome of chronic Lisfranc injury without secondary degenerative arthritis: a systematic literature review. Injury, 2020, 51(6): 1258-1265.
4.	Welck M, Zinchenko R, Tudor F. A painful foot: Lisfranc fracture-dislocations. BMJ, 2016, 352: i882.
5.	Joannas G, Filippi J. How to identify unstable Lisfranc injuries? Review of diagnostic strategies and algorithm proposal. Foot Ankle Clin, 2020, 25(4): 697-710.
6.	Lau S, Bozin M, Thillainadesan T. Lisfranc fracture dislocation: a review of a commonly missed injury of the midfoot. Emerg Med J, 2017, 34(1): 52-56.
7.	吴仕舟, 秦博泉, 解慧琪, 等. 切开复位内固定治疗新鲜与陈旧隐性 Lisfranc 损伤的比较研究. 中国修复重建外科杂志, 2019, 33(8): 965-969.
8.	Bevilacqua NJ. Tarsometatarsal arthrodesis for Lisfranc injuries. Clin Podiatr Med Surg, 2017, 34(3): 315-325.
9.	Philbin T, Rosenberg G, Sferra JJ. Complications of missed or untreated Lisfranc injuries. Foot Ankle Clin, 2003, 8(1): 61-71.
10.	Granberry WM, Lipscomb PR. Dislocation of the tarsometatarsal joints. Surg Gynecol Obstet, 1962, 114: 467-469.
11.	Mulier T, Reynders P, Dereymaeker G, et al. Severe Lisfrancs injuries: primary arthrodesis or ORIF? Foot Ankle Int, 2002, 23(10): 902-905.
12.	Chiodo CP, Myerson MS. Developments and advances in the diagnosis and treatment of injuries to the tarsometatarsal joint. Orthop Clin North Am, 2001, 32(1): 11-20.
13.	Myerson MS, Cerrato RA. Current management of tarsometatarsal injuries in the athlete. J Bone Joint Surg Am, 2008, 90(11): 2522-2533.
14.	冯品, 李嘉, 欧阳翔宇, 等. 陈旧性 Lisfranc 损伤分期治疗的短期随访结果. 国际外科学杂志, 2016, 43(11): 745-749.
15.	Kellgren JH, Lawrence JS. Radiological assessment of osteo-arthrosis. Ann Rheum Dis, 1957, 16(4): 494-502.
16.	Huskisson EC. Measurement of pain. Lancet, 1974, 2(7889): 1127-1131.
17.	Kitaoka HB, Alexander IJ, Adelaar RS, et al. Clinical rating systems for the ankle-hindfoot, midfoot, hallux, and lesser toes. Foot Ankle Int, 1994, 15(7): 349-353.
18.	Jenkinson C, Layte R. Development and testing of the UK SF-12 (short form health survey). J Health Serv Res Policy, 1997, 2(1): 14-18.
19.	van Rijn J, Dorleijn DM, Boetes B, et al. Missing the Lisfranc fracture: a case report and review of the literature. J Foot Ankle Surg, 2012, 51(2): 270-274.
20.	Moracia-Ochagavía I, Rodríguez-Merchán EC. Lisfranc fracture-dislocations: current management. EFORT Open Rev, 2019, 4(7): 430-444.
21.	王晓康, 顾文奇, 蒋剑涛, 等. 选择性跖跗关节融合术治疗陈旧性 Lisfranc 损伤. 中华医学杂志, 2019, 99(21): 1626-1630.
22.	陈宇, 张晖, 李亚星, 等. 改良 JAPAS 截骨治疗陈旧性 Lisfranc 复合体损伤继发僵硬高弓畸形. 中华骨与关节外科杂志, 2020, 13(7): 538-542,547.
23.	Dubois-Ferrière V, Lübbeke A, Chowdhary A, et al. Clinical outcomes and development of symptomatic osteoarthritis 2 to 24 years after surgical treatment of tarsometatarsal joint complex injuries. J Bone Joint Surg Am, 2016, 98(9): 713-720.
24.	Feng P, Li YX, Li J, et al. Staged management of missed lisfranc injuries: a report of short-term results. Orthop Surg, 2017, 9(1): 54-61.
25.	Tantray MD, Kangoo K, Nazir A, et al. An old mismanaged Lisfranc injury treated by gradual deformity correction followed by the second-stage internal fixation. Strategies Trauma Limb Reconstr, 2017, 12(1): 59-62.
26.	陈柯屹, 巫宗德, 彭亮, 等. 关节融合与内固定治疗 Lisfranc 损伤的荟萃分析. 中国矫形外科杂志, 2018, 26(12): 1107-1112.
27.	Qiao YS, Li JK, Shen H, et al. Comparison of arthrodesis and non-fusion to treat Lisfranc injuries. Orthop Surg, 2017, 9(1): 62-68.

1. Ponkilainen VT, Laine HJ, Mäenpää HM, et al. Incidence and characteristics of midfoot injuries. Foot Ankle Int, 2019, 40(1): 105-112.
2. 李莹, 李文菁, 孙宁, 等. 陈旧性 Lisfranc 损伤手术治疗的中短期疗效分析. 中华创伤骨科杂志, 2022, 24(1): 19-24.
3. Sripanich Y, Weinberg MW, Krähenbühl N, et al. Surgical outcome of chronic Lisfranc injury without secondary degenerative arthritis: a systematic literature review. Injury, 2020, 51(6): 1258-1265.
4. Welck M, Zinchenko R, Tudor F. A painful foot: Lisfranc fracture-dislocations. BMJ, 2016, 352: i882.
5. Joannas G, Filippi J. How to identify unstable Lisfranc injuries? Review of diagnostic strategies and algorithm proposal. Foot Ankle Clin, 2020, 25(4): 697-710.
6. Lau S, Bozin M, Thillainadesan T. Lisfranc fracture dislocation: a review of a commonly missed injury of the midfoot. Emerg Med J, 2017, 34(1): 52-56.
7. 吴仕舟, 秦博泉, 解慧琪, 等. 切开复位内固定治疗新鲜与陈旧隐性 Lisfranc 损伤的比较研究. 中国修复重建外科杂志, 2019, 33(8): 965-969.
8. Bevilacqua NJ. Tarsometatarsal arthrodesis for Lisfranc injuries. Clin Podiatr Med Surg, 2017, 34(3): 315-325.
9. Philbin T, Rosenberg G, Sferra JJ. Complications of missed or untreated Lisfranc injuries. Foot Ankle Clin, 2003, 8(1): 61-71.
10. Granberry WM, Lipscomb PR. Dislocation of the tarsometatarsal joints. Surg Gynecol Obstet, 1962, 114: 467-469.
11. Mulier T, Reynders P, Dereymaeker G, et al. Severe Lisfrancs injuries: primary arthrodesis or ORIF? Foot Ankle Int, 2002, 23(10): 902-905.
12. Chiodo CP, Myerson MS. Developments and advances in the diagnosis and treatment of injuries to the tarsometatarsal joint. Orthop Clin North Am, 2001, 32(1): 11-20.
13. Myerson MS, Cerrato RA. Current management of tarsometatarsal injuries in the athlete. J Bone Joint Surg Am, 2008, 90(11): 2522-2533.
14. 冯品, 李嘉, 欧阳翔宇, 等. 陈旧性 Lisfranc 损伤分期治疗的短期随访结果. 国际外科学杂志, 2016, 43(11): 745-749.
15. Kellgren JH, Lawrence JS. Radiological assessment of osteo-arthrosis. Ann Rheum Dis, 1957, 16(4): 494-502.
16. Huskisson EC. Measurement of pain. Lancet, 1974, 2(7889): 1127-1131.
17. Kitaoka HB, Alexander IJ, Adelaar RS, et al. Clinical rating systems for the ankle-hindfoot, midfoot, hallux, and lesser toes. Foot Ankle Int, 1994, 15(7): 349-353.
18. Jenkinson C, Layte R. Development and testing of the UK SF-12 (short form health survey). J Health Serv Res Policy, 1997, 2(1): 14-18.
19. van Rijn J, Dorleijn DM, Boetes B, et al. Missing the Lisfranc fracture: a case report and review of the literature. J Foot Ankle Surg, 2012, 51(2): 270-274.
20. Moracia-Ochagavía I, Rodríguez-Merchán EC. Lisfranc fracture-dislocations: current management. EFORT Open Rev, 2019, 4(7): 430-444.
21. 王晓康, 顾文奇, 蒋剑涛, 等. 选择性跖跗关节融合术治疗陈旧性 Lisfranc 损伤. 中华医学杂志, 2019, 99(21): 1626-1630.
22. 陈宇, 张晖, 李亚星, 等. 改良 JAPAS 截骨治疗陈旧性 Lisfranc 复合体损伤继发僵硬高弓畸形. 中华骨与关节外科杂志, 2020, 13(7): 538-542,547.
23. Dubois-Ferrière V, Lübbeke A, Chowdhary A, et al. Clinical outcomes and development of symptomatic osteoarthritis 2 to 24 years after surgical treatment of tarsometatarsal joint complex injuries. J Bone Joint Surg Am, 2016, 98(9): 713-720.
24. Feng P, Li YX, Li J, et al. Staged management of missed lisfranc injuries: a report of short-term results. Orthop Surg, 2017, 9(1): 54-61.
25. Tantray MD, Kangoo K, Nazir A, et al. An old mismanaged Lisfranc injury treated by gradual deformity correction followed by the second-stage internal fixation. Strategies Trauma Limb Reconstr, 2017, 12(1): 59-62.
26. 陈柯屹, 巫宗德, 彭亮, 等. 关节融合与内固定治疗 Lisfranc 损伤的荟萃分析. 中国矫形外科杂志, 2018, 26(12): 1107-1112.
27. Qiao YS, Li JK, Shen H, et al. Comparison of arthrodesis and non-fusion to treat Lisfranc injuries. Orthop Surg, 2017, 9(1): 62-68.

West China Medical Journal

Clinical efficacy of selective tarsometatarsal arthrodesis for old Lisfranc injuries

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