Limits...
Outcome comparison of Lisfranc injuries treated through dorsal plate fixation versus screw fixation.

Hu SJ, Chang SM, Li XH, Yu GR - Acta Ortop Bras (2014)

Bottom Line: Evaluation was performed with patients' chief complaint, clinical examination, radiography, and AOFAS Midfoot Scale.Open reduction and dorsal plate fixation for a dislocated Lisfranc injury do have better short and median term outcome and a lower reoperation rate than standard screw ORIF.Level of Evidence II, Prospective Comparative Study.

View Article: PubMed Central - PubMed

Affiliation: Tongji University, School of Medicine, Yangpu Hospital, People's Republic of China, Department of Orthopedic Surgery, Yangpu Hospital, Tongji University School of Medicine, People's Republic of China.

ABSTRACT

Objective: The objective of this prospective study was to test whether the treatment of Lisfranc injuries with open reduction and dorsal plate fixation would have the same or better functional outcomes as treatment with standard trans-articular screw fixation.

Methods: Sixty patients with primarily isolated Lisfranc joint injury were treated by open reduction and dorsal plate fixation or standard screw fixation. The patients were followed on average for 31 months. Evaluation was performed with patients' chief complaint, clinical examination, radiography, and AOFAS Midfoot Scale.

Results: Thirty two patients were treated with open reduction and dorsal plate fixation, and twenty eight patients were treated with open reduction and screw fixation. After two years follow-up, the mean AOFAS Midfoot score was 83.1 points in the dorsal plate fixation group and 78.5 points in the screw fixation group (p<0.01). Of the dorsal plate fixation group, radiographic analysis revealed anatomic reduction in twenty-nine patients (90.6%, 29/32) and nonanatomic reduction in three patients. Of the screw fixation group, radiographic analysis revealed anatomic reduction in twenty-three patients and nonanatomic reduction in five patients (82.1%, 23/28).

Conclusions: Open reduction and dorsal plate fixation for a dislocated Lisfranc injury do have better short and median term outcome and a lower reoperation rate than standard screw ORIF. In our experience, we recommend using dorsal plate in ORIF on dislocated Lisfranc injuries. Level of Evidence II, Prospective Comparative Study.

No MeSH data available.


Related in: MedlinePlus

Case 1: Female 38 yer as old Myerson I type, X-radiograph before operation; X-radiograph shows the fracture-dislocation healed two weeks and six months post-operation.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4273957&req=5

f03: Case 1: Female 38 yer as old Myerson I type, X-radiograph before operation; X-radiograph shows the fracture-dislocation healed two weeks and six months post-operation.

Mentions: Functional outcome was measured by the AOFAS Midfoot Scale (Table 2). In group 1, the final mean score was 83.1(range, 41-100). Thirteen patients had excellent outcome (score≥90); Fourteen patients had good outcome (90>score≥75); Four patients had fair outcome(75>score≥50) and one patients had poor outcome (score<49). Six patients had mild discomfort on prolonged walking and five patients had reduced mobility subjectively. None of the patients were using modified footwear at final follow-up. A typical case with Myerson I type fracture-dislocation treated with dorsal plates is seen Figure 3. In group 2, the final mean score was 78.5 (range, 38-100). Eight patients had excellent outcome; thirteen patients had good outcome; four patients had fair outcome and three patients had poor outcome. The three people who had poor outcome also underwent secondly arthrodesis of TMT joints. Ten patients had mild discomfort on prolonged walking and nine patients had reduced mobility subjectively. A typical case with Myerson IIB type fracture-dislocation treated with screws and Kirschner wire is seen Figure 4. After 2 years follow-up the final AOFAS score in dorsal fixation group is higher than screw fixation group (p<0.01) .


Outcome comparison of Lisfranc injuries treated through dorsal plate fixation versus screw fixation.

Hu SJ, Chang SM, Li XH, Yu GR - Acta Ortop Bras (2014)

Case 1: Female 38 yer as old Myerson I type, X-radiograph before operation; X-radiograph shows the fracture-dislocation healed two weeks and six months post-operation.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4273957&req=5

f03: Case 1: Female 38 yer as old Myerson I type, X-radiograph before operation; X-radiograph shows the fracture-dislocation healed two weeks and six months post-operation.
Mentions: Functional outcome was measured by the AOFAS Midfoot Scale (Table 2). In group 1, the final mean score was 83.1(range, 41-100). Thirteen patients had excellent outcome (score≥90); Fourteen patients had good outcome (90>score≥75); Four patients had fair outcome(75>score≥50) and one patients had poor outcome (score<49). Six patients had mild discomfort on prolonged walking and five patients had reduced mobility subjectively. None of the patients were using modified footwear at final follow-up. A typical case with Myerson I type fracture-dislocation treated with dorsal plates is seen Figure 3. In group 2, the final mean score was 78.5 (range, 38-100). Eight patients had excellent outcome; thirteen patients had good outcome; four patients had fair outcome and three patients had poor outcome. The three people who had poor outcome also underwent secondly arthrodesis of TMT joints. Ten patients had mild discomfort on prolonged walking and nine patients had reduced mobility subjectively. A typical case with Myerson IIB type fracture-dislocation treated with screws and Kirschner wire is seen Figure 4. After 2 years follow-up the final AOFAS score in dorsal fixation group is higher than screw fixation group (p<0.01) .

Bottom Line: Evaluation was performed with patients' chief complaint, clinical examination, radiography, and AOFAS Midfoot Scale.Open reduction and dorsal plate fixation for a dislocated Lisfranc injury do have better short and median term outcome and a lower reoperation rate than standard screw ORIF.Level of Evidence II, Prospective Comparative Study.

View Article: PubMed Central - PubMed

Affiliation: Tongji University, School of Medicine, Yangpu Hospital, People's Republic of China, Department of Orthopedic Surgery, Yangpu Hospital, Tongji University School of Medicine, People's Republic of China.

ABSTRACT

Objective: The objective of this prospective study was to test whether the treatment of Lisfranc injuries with open reduction and dorsal plate fixation would have the same or better functional outcomes as treatment with standard trans-articular screw fixation.

Methods: Sixty patients with primarily isolated Lisfranc joint injury were treated by open reduction and dorsal plate fixation or standard screw fixation. The patients were followed on average for 31 months. Evaluation was performed with patients' chief complaint, clinical examination, radiography, and AOFAS Midfoot Scale.

Results: Thirty two patients were treated with open reduction and dorsal plate fixation, and twenty eight patients were treated with open reduction and screw fixation. After two years follow-up, the mean AOFAS Midfoot score was 83.1 points in the dorsal plate fixation group and 78.5 points in the screw fixation group (p<0.01). Of the dorsal plate fixation group, radiographic analysis revealed anatomic reduction in twenty-nine patients (90.6%, 29/32) and nonanatomic reduction in three patients. Of the screw fixation group, radiographic analysis revealed anatomic reduction in twenty-three patients and nonanatomic reduction in five patients (82.1%, 23/28).

Conclusions: Open reduction and dorsal plate fixation for a dislocated Lisfranc injury do have better short and median term outcome and a lower reoperation rate than standard screw ORIF. In our experience, we recommend using dorsal plate in ORIF on dislocated Lisfranc injuries. Level of Evidence II, Prospective Comparative Study.

No MeSH data available.


Related in: MedlinePlus