Lisfranc Joint Injuries
Lisfranc Joint consists of three cuneiform and two cuboid metatarsal articulations.
Stability- strong ligament and recessing of second metatarsal head.
Lisfranc ligament - base of 2nd metatarsal to medial cuneiforms.
How to proceed to this type of injuries ?
Always a trauma case management quires ATLS approach,
Analgesia
Elevation
Resting/ Splinting
Rule out Compartment Syndrome
Radiographs - AP / Oblique
If needed CT
wait swelling to subside (skin softening , wrinkles )
What we see on X-ray ?
AP view - 2nd MT and medial cuneiform medial borders align
Oblique - medial border of 4th MT and cuboid align.
fleck sign - avulsion of Lisfranc ligament.
https://www.orthointerview.com/News/post/?permalink=core-knowledge-lisfranc-injury
Classification of Lisfranc Injuries
Type A - Unipolar dislocation involving whole joint
B - Partial dislocation -medial or lateral
C - Divergent
https://drhem.wordpress.com/tag/trauma/page/2/
How to manage such cases ?
Open or Closed Reduction
Screws / K-wire Fixation
start with 2nd MT reduction
two skin incision
one over 1st web space
2nd over 4th MT
Chances of post-traumatic Osteoarthritis is 30 % in long term.
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