• Journal of Korean Foot and Ankle Society
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• v.16 no.4
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• pp.203-209
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• 2012

Lisfranc joint injuries are rare and account for 0.2% of all injuries. The pattern of Lisfranc injuries varies from low-energy ligamentous sprain to high-energy fractures or crushing injuries. Early diagnosis and appropriate treatment of Lisfranc injuries are important to prevent chronic foot pain and dysfunction.

• Journal of Korean Foot and Ankle Society
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• v.24 no.4
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• pp.165-167
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• 2020

Failure to achieve stable fixation during surgery for a Lisfranc joint injury leads to subtle instability that causes dysfunction and posttraumatic osteoarthritis. Therefore, it is important to check for appropriate fixation during surgery. This paper reports a test that evaluates the joint instability dynamically during the open reduction of the Lisfranc joint and checks the stability after fixation. a Freer elevator was inserted into the interosseous area between the medial cuneiform and second metatarsal base, and a twisting force was applied to evaluate the dynamic instability of the Lisfranc joint. After fixation of the Lisfranc joint, the stability of the fixation could be tested by trying this maneuver with the Freer elevator. Overall, the Freer test can be considered a valuable test in open surgery for a Lisfranc joint injury.

• Journal of Korean Foot and Ankle Society
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• v.1 no.1
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• pp.43-50
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• 1997

The tarsometatarsal joint complex is formed by articulation of the five metatarsal bases with the three cuneiform bones and the cuboid bone. Fracture-dislocation of tarsometatarsal area are difficult to recognize on standard radiographs. The exact diagnosis is occasionally delayed. As a result, improper treatment and late sequelae remains. We decided to make a study of patients with normal foot radiographs on 200 cases. Standard radiographic evaluation was used to study the normal variants of the foot and to evaluate the coincided alignment of the lisfranc joint. Accurate accessment on AP & lateral & $30^{\circ}$ oblique projection of radiographs are very adventageous & important, and next final outcome was detected. : 1. Coincided alignment below 1mm and unfolded lisfranc joint on AP projection was well visalized on 1st cuneiform-metatarsal lateral border and 2nd cuneiform-metatarsal medial border. 2. Coincided alignment below 1mm and unfolded lisfranc joint on oblique projection was well visualized on 2nd cuneiform-metatarsal lateral border and 3rd cuneiform-metatarsal medial border and 3rd cuneform-metatarsal lateral border. 3. More proximal location of 2nd lisfranc joint compared to another joint was 196 cases (98%). It is due to inceleration of 2nd metatarsal base between 3rd & 1st cuneiform. 4. 3rd lisfranc joint was volarward position compared to 2nd listranc on lateral projection at 191 cases (95.5%). It's due to anterior covexity of lisfranc joint. 5. Wide dorsal sided 2nd lisfranc is investigated at 189 cases (94.5%). Because of it. 2nd & 3rd lisfrances are mainly volar dislocated usually. 6. Notching on 5th metatarsal base is visible on 171 cases (85.5%). 7. 4th lisfranc joint had offset normally within $2\sim3mm$ at 98 cases (49%). 8. 5th Lisfranc joint had normally offset within $2\sim3mm$ at 99 cases (49.5%). 9. On lateral projection, slight dorsal location of cuneiform to metatarsal base is investigated at 82 cases (41%).

• Journal of Korean Foot and Ankle Society
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• v.20 no.3
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• pp.106-111
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• 2016

The Lisfranc joint complex is an anatomical association of many bones and articulation, restrained by an even more complex network of ligaments, capsules, and fascia, which must work in concert to provide normal and painless motion. Careful diagnostic workup with high-quality radiographs and computed tomography of the foot are used to diagnose injuries and fractures of this complex. We have to understand the normal anatomy and injury mechanism in order to appropriately treat Lisfranc injuries. Good results have been associated with anatomic reductions of all bones, which was achieved with restoration of proper alignment.

• Journal of Korean Foot and Ankle Society
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• v.8 no.1
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• pp.71-75
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• 2004

Purpose: The purpose of this study was to evaluate retrospectively the clinical results of closed reduction and percutaneous screw fixation for unstable injuries on stress radiographs in subtle injuries of Lisfranc joint. Materials and Methods: From June 1997 to March 2003, 6 cases of unstable injuries on stress radiograph in subtle injuries of Lisfranc joint were treated by percutaneous cannulated screw fixation after closed reduction. All cases were injuried by indirect force (twisting injury). The average diastasis between the 1st and 2nd metatarsal base was 3 mm (2-4 mm) on initial nonweight bearing AP radiograph. The average follow-up period was 20 months. Clinical evaluation was assessed according to the American Orthopedic Foot and Ankle Society (AOFAS) midfoot score. Results: The AOFAS midfoot score was average 86 (80-90) points. The average diastasis between 1st and 2nd metatarsal base was 2 mm (1-3 mm) on weight bearing AP radiograph in final follow up. The final diastasis was increased slightly than diastasis in initial postoperative radiographs. But the clinical results were good. There was no correlation between the degree of diastasis and the clinical results. On weight bearing lateral radiograph, the average difference with normal foot in the distance between plantar aspect of 5th metatarsus and medial cuneiform was 2 mm (0-3 mm). One case had mild arthritic change on the radiographs. Conclusion: When the Lisfranc injuries, especially in the subtle injuries were suspicious, the stress views are helpful to assess stability of the Lisfranc injuries and planning of treatment. For unstable injuries on stress radiographs in subtle injuries of Lisfranc joint, closed reduction and percutaneous screw fixation is useful method to expect good clinical results.

• Journal of Acupuncture Research
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• v.34 no.4
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• pp.197-200
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• 2017

The effects of acupuncture treatment and taping therapy on a 22-year-old man who suffered from left foot pain due to Lisfranc joint injury were examined. Fractures of the first, second, and third metatarsal bones and a cuneiform bone were treated with acupuncture and taping therapy from March 24, 2017 to May 4, 2017. The patient was evaluated using the American Orthopaedic Foot & Ankle Society's Ankle-Hindfoot Scale. His Ankle-Hindfoot Score increased from 27 points pre-treatment to 65 points post-treatment. There were no side effects. While the improvement observed in this patient is encouraging, no definitive conclusion on the effects of acupuncture treatment and taping therapy on Lisfranc joint injuries can be reached without further large-scale study.

• Journal of Korean Foot and Ankle Society
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• v.19 no.4
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• pp.181-187
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• 2015

Purpose: The purpose of this study is to retrospectively analyze the clinical results of screws and Kirschner wire (K-wire) fixation in patients with fracture dislocation of Lisfranc joint and the consequence of screw breakage. Materials and Methods: Sixty patients underwent Lisfranc joint open reduction and removal of internal fixators from January 2007 to December 2011. Forty-nine cases (81.7%) underwent operations with screw alone, and 11 cases (18.3%) underwent operations with both screws and K-wires. Type of internal fixators, duration of internal fixator removal, breakage of internal fixators and satisfaction with reduction were investigated. Additionally, American Orthopaedic Foot and Ankle Society (AOFAS) midfoot scales were analyzed. Results: The internal fixator was broken in 5 cases (8.3%). The average duration of instrument removal was 154 days in the non-broken screw group and 268.6 days in the broken screw group (p<0.05). The average AOFAS midfoot scale was 77.4 in the non-broken screw group and 74.2 in the broken screw group. The most commonly damaged portion was the first tarsometatarsal (Lisfranc) joint. Conclusion: Treatment with screws and K-wires was effective in patients with fracture dislocation of Lisfranc joint. The appropriate time for screw removal should be considered.

• Journal of Korean Foot and Ankle Society
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• v.17 no.1
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• pp.34-39
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• 2013

Purpose: To evaluate the effectiveness of intraoperative stress test for diagnosis of occult Lisfranc injury. Materials and Methods: Between April 2009 and October 2012, 21 patients with occult Lisfranc injuries underwent intraoperative stress test and internal fixation. There were 11 males and 10 females with an average age of 45.3 years (range, 23~79 years). Injuries were caused by traffic accident in 10 cases, indirect force (twisting injury) in 8 cases, and crush in 2 cases, falling from a height in 1 case. Unstable injuries on stress radiograph in occult injury of Lisfranc joint were treated by open reduction or closed reduction and fixation with cannulated screw or K-wire. Radiological evaluation was assessed according to preoperative and postoperative diastasis between $1^{st}$ and $2^{nd}$ metatarsal base. Results: Assoicated injuries were 9 cases of metatarsal fractures, 6 cases of cuneiform fractures and 6 cases of both metatarsal and cuneiform fractures. Medial and middle column fixation was in 13 cases, and three columns fixation was in 8 cases. Initial diastasis between $1^{st}$ and $2^{nd}$ metatarsal base was 2.8 mm (1.3~4.7 mm) on AP radiograph and postoperative diastasis between $1^{st}$ and $2^{nd}$ metatarsal base was 1.2 mm (0.5~2.4 mm) on AP radiograph. Conclusion: Even there is no sign of clear Lisfranc injury, it is necessary to pay attention and give evaluation on circumstances of occult Lisfranc injuries with metatarsal or cuneiform fractures. Intraoperative stress test is helpful to diagnose an occult Lisfranc injury. For unstable injuries on stress radiographs of occult Lisfranc joint injury, operative treatment with open or closed reduction and internal fixation is useful method.

• Journal of Korean Foot and Ankle Society
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• v.18 no.3
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• pp.124-128
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• 2014

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.

• Journal of Korean Foot and Ankle Society
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• v.8 no.2
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• pp.182-190
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• 2004

Purpose: To evaluate the clinical feature and the results of the treatment of Lisfranc joint fracture/dislocation with limited open reduction, pin fixation and Ilizarov external fixation. Materials and Methods: From June 2001 to May 2003, six patients with Lisfranc fracture/dislocation were treated. The average periods of follow-up was 23 months. After limited open reduction on the second tarso-metatarsal joint, we performed pin fixation of the above joint. On the other Lisfranc joint fracture/dislocation, closed reduction and the application of Ilizarov external fixator was done. This rigid system produced the early partial weight bearing and joint motion of the injured foot and ankle joint. The parameters used were radiographic evaluation, patient's clinical assesment and the AOFAS midfoot score. Results: We used the Myerson's criterier to evaluate the radiographic result. All cases could be achieved more than nearly anatomical reduction. Three cases of excellent and 3 cases of good result could be obtained in the evaluation of the patient's clinical assesment. The average AOFAS midfoot score was 87.2 ($76{\sim}95$) points. Conclusion: The treatment using Ilizarov external fixation on Lisfranc joint fracture/dislocation can be another useful method.