Analysis of Clinical Outcome and Prognosis for Lisfranc Joint Fracture and Dislocation according to the Injury Mechanism and Treatment Method

Hyun-Woo Park; Hyung Suk Yi

doi:10.14193/jkfas.2014.18.3.124

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Park and Yi: Analysis of Clinical Outcome and Prognosis for Lisfranc Joint Fracture and Dislocation according to the Injury Mechanism and Treatment Method

Original Article

J Korean Foot Ankle Soc 2014;18(3):124-128.

Published online: 19 September 2014

DOI: https://doi.org/10.14193/jkfas.2014.18.3.124

Analysis of Clinical Outcome and Prognosis for Lisfranc Joint Fracture and Dislocation according to the Injury Mechanism and Treatment Method

Hyun-Woo Park, Hyung Suk Yi

Department of Orthopaedic Surgery, Dankook University Hospital, Cheonan, Korea

Corresponding Author: Hyun-Woo Park Department of Orthopaedic Surgery, Dankook University Hospital, 201 Manghyang-ro, Dongnam-gu, Cheonan 330-715, Korea Tel: 82-41-550-3296, Fax: 82-41-556-0524, E-mail: m3artist@hanmail.net

Received 31 March 201426 April 2014 Accepted 29 May 2014

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose:

The purpose of this study was to assess the treatment outcomes and prognosis of Lisfranc joint fracture and dislocation according to the mechanism of injury and treatment method.

Materials and Methods:

Twenty six patients with Lisfranc fracture-dislocation who had been treated surgically were included in this retrospective study. The patients were divided into two groups according to mechanism of injury: direct crushing injury (16 patients) and indirect rotational or compressive injury (10 patients). The patients were also divided into three groups according to the surgical methods. The parameters used were radiographic evaluation, patients’ subjective satisfaction levels, length of hospital stay, and the American Orthopaedic Foot and Ankle Society (AOFAS) midfoot score. Statistical analysis was performed.

Results:

The mean postoperative AOFAS midfoot score was 78.7. The mean length of stay was 39.6 days. Statistically significant differences in subjective satisfaction, AOFAS midfoot score, and length of hospital stay were observed between the two groups (p<0.05). However, no significance differences were observed between the three groups who were divided according to the different surgical methods (p>0.05).

Conclusion:

Mechanism of trauma and the severity of soft-tissue injury were significant prognostic factors affecting the surgical outcomes of Lisfranc joint fracture and dislocation.

Keywords: Lisfranc joint, Fracture and dislocation, Injury mechanism

REFERENCES

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Figure 1.

(A) Preoperative anteroposterior radiograph of left foot showed fracture and dislocation of Lisfranc joint. (B) Postoperative anteroposterior radiograph of left foot showed well reduced fracture and dislocation with cannulated screw fixation.

Figure 2.

Figure 3.

(A) Preoperative anteroposterior radiograph of right foot showed fracture and dislocation of Lisfranc joint. (B) Preoperative lateral radiograph of right foot showed fracture and dislocation of Lisfranc joint. (C) Postoperative anteroposterior radiograph of right foot showed well reduced fracture and dislocation of Lisfranc joint using Ilizarov external fixator. (D) Postoperative lateral radiograph of right foot showed well reduced fracture and dislocation of Lisfranc joint using Ilizarov external fixator.

Table 1.

Summary of Cases

Case no.	Trauma mechanism	Sex	Age (yr)	Operation method	Myerson classification
1	Direct	Male	32	OR	A (lateral)
2	Indirect	Male	25	OR	B2
3	Indirect	Male	46	CR	B2
4	Indirect	Male	32	CR	B2
5	Indirect	Male	33	OR	C1
6	Direct	Male	28	CR	B1
7	Direct	Female	16	OR	C1
8	Direct	Female	68	OR	C2
9	Direct	Male	34	OR	B2
10	Direct	Male	22	OR	B2
11	Direct	Male	34	OR	C1
12	Direct	Male	15	OR	B1
13	Direct	Male	45	CR	C1
14	Direct	Male	22	CREF	A (dorsoplantar)
15	Indirect	Male	49	OR	C2
16	Direct	Male	64	CREF	A (lateral)
17	Direct	Male	28	CREF	B1
18	Direct	Male	50	OR	B2
19	Indirect	Female	24	OR	B1
20	Direct	Male	75	OR	B1
21	Indirect	Female	56	OR	B1
22	Direct	Male	49	CREF	B2
23	Indirect	Male	31	CR	A (lateral)
24	Indirect	Male	43	OR	44
25	Indirect	Male	65	OR	A (lateral)
26	Direct	Female	82	CR	B2

OR: open reduction and internal fixation, CR: closed reduction and percutaneous pinning, CREF: closed reduction and external fixation.

Table 2.

Reduction Accuracy and Clinical Outcomes of All Patients

Case no.	Reduction accuracy	AOFAS midfoot score	LOM	Subjective satisfaction	LOS
1	Anatomical	81	+	4	16
2	Anatomical	82	―	4	18
3	Anatomical	87	―	5	11
4	Anatomical	92	―	5	23
5	Anatomical	90	―	5	19
6	Anatomical	72	+	3	33
7	Satisfactory	68	+	2	63
8	Unsatisfactory	65	+	2	127
9	Satisfactory	72	+	3	41
10	Anatomical	81	+	4	114
11	Anatomical	81	―	4	8
12	Anatomical	64	―	2	84
13	Anatomical	82	―	4	24
14	Anatomical	93	―	5	79
15	Unsatisfactory	51	+	2	28
16	Anatomical	82	+	4	18
17	Satisfactory	92	+	5	24
18	Satisfactory	75	―	3	87
19	Anatomical	92	―	5	7
20	Satisfactory	79	―	3	79
21	Anatomical	92	―	5	15
22	Anatomical	72	+	3	23
23	Satisfactory	89	―	5	6
24	Anatomical	82	―	5	21
25	Satisfactory	82	―	5	17
26	Unsatisfactory	48	―	2	45

AOFAS: American Orthopaedic Foot and Ankle Society, LOM: limitation of motion, LOS: length of hospital stay.

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