Lisfranc Joint Ligament Complex Reconstruction: A Promising Solution for Missed, Delayed, or Chronic Lisfranc Injury Without Arthritis

The current classifications of “Lisfranc injury” can be purely ligamentous (low-grade midfoot sprains) or involve the osseous and articular structures (high-grade Lisfranc fracture displacements). The first type is often difficult to detect. If these patients are not properly treated, long-term disa...

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Bibliographic Details
Published in:The Journal of foot and ankle surgery 2017-11, Vol.56 (6), p.1350-1356
Main Authors: De los Santos-Real, Raúl, Canillas, Fernando, Varas-Navas, Jesús, Morales-Muñoz, Patricia, Barrio-Sanz, Patricia, Medina-Santos, Mónica
Format: Article
Language:English
Subjects:
Adult
Bone Screws
Chronic Disease
cuneiform
Delayed Diagnosis
Diagnostic Errors
Female
Follow-Up Studies
Foot Joints - diagnostic imaging
Foot Joints - injuries
Foot Joints - surgery
foot surgery
Fracture Fixation, Internal - instrumentation
Fracture Fixation, Internal - methods
Gracilis Muscle - blood supply
Gracilis Muscle - transplantation
gracilis tendon
Humans
ligamentoplasty
Ligaments, Articular - diagnostic imaging
Ligaments, Articular - injuries
Ligaments, Articular - surgery
Lisfranc injury
Reconstructive Surgical Procedures - methods
Sampling Studies
Surgical Flaps - blood supply
Surgical Flaps - transplantation
Treatment Outcome
Young Adult
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Summary:The current classifications of “Lisfranc injury” can be purely ligamentous (low-grade midfoot sprains) or involve the osseous and articular structures (high-grade Lisfranc fracture displacements). The first type is often difficult to detect. If these patients are not properly treated, long-term disability can result. The rate of missed or delayed diagnoses has ranged from 13% to 24%, primarily owing to the subtlety of the radiographic findings. This is relatively more common in cases of subtle ligamentous injury (19%). The aim of the present report was to provide a new technique for missed or delayed Lisfranc injury without degenerative local signs. The Lisfranc ligament complex reconstruction is performed with a gracilis tendon graft and is protected by temporary screw fixation. We performed this technique in 3 patients. All 3 patients obtained good results, have been able to resume their previous activities, and have stated they would undergo this type of procedure again. The minimum follow-up length was 2 years.
ISSN:1067-2516
1542-2224
DOI:10.1053/j.jfas.2017.06.025