Fracture & Dislocation of Tarso-metatarsal Joint

Kang, Eung Shick; Kang, Ho Jung; Yang, Ick Hwan; Lee, Dong Wha

Abstract

The fracture and dislocation of tarso-metatarsal joint is rare injury, but if it occurs, as-sociated soft tissue injury is so severe according to its cause of injury. We reviewed 19 patients of fracture and dislocation of tarso-metatarsal joint who were treated in patient service, during the perlod, from April, 1981 to March, 1991 at our hospital. The results were as follows; 1. Fifteen patients (75%) among the 19 patients were injured due to traffic accident and the associated injury was so severe. 2. Nine cases were treated with percutaneous pinning, closed redoclion with cast immobilization in 2 cases and open reduction with multiple pinning in 8 cases. Three cases needed free vasculariaed flap for its extensive soft tissue injury and, one case was taken below knee amputation for its associatrd severe injury. 3. Anatomical reduction was achieved in 15 cases and iss results were as follows: good in 4 cases. fair in 10 cases and poor in one case Anatomical reduction was not achieved in 3 cases and the results were as follows : fair in one case and poor in 2 cases. 4. Eight cases which were treated with open reduction with multiple pinning had the results as follows: good in one. fair in 6 cases and the remaining one case had taken below knee amputation Seven cases which were treated with closed reductlon and cast immobiliza- cases and poor in 3 cases. 5. The patients who were achieved anatomical reduction had better results than who were not achieved anatomical reduction, Buy the results of all patients were not so satisractory. That is because of the point that the Lisfranc joint injury had associated with severe soft tissue injuries. We concluded that early and active intervention and anatomical reduction should be achieved for the better results.