J Korean Foot Ankle Soc.  2015 Dec;19(4):181-187. 10.14193/jkfas.2015.19.4.181.

Fracture and Dislocation of Lisfranc Joint: Treatment with Screw and Kirschner Wire

• Ha DJ
• Kim JG
• Gwak HC
• Jang YC

• KMID: 2132462
• DOI: http://doi.org/10.14193/jkfas.2015.19.4.181

Abstract

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.

Keyword

Tarsal joint; Lisfranc joint; Bone screw; Kirschner wire; Breakage

MeSH Terms

Ankle
Bone Screws
Dislocations*
Foot
Humans
Internal Fixators
Joints*
Retrospective Studies
Tarsal Joints
Weights and Measures

Figure

• 

  Figure 1. Broken screw case. (A) Preoperative anteroposterior (AP) weightbearing radiograph is shown for a patient with fracture dislocation of Lisfranc joint. (B) Postoperative AP radiograph shows well reduced Lisfranc joint with two screws. (C) AP radiograph shows broken screw. (D) Postoperative AP radiograph shows broken screw remnant in middle cuneiform bone.

• 

  Figure 2. Non-broken screw case. (A) Preoperative anteroposterior (AP) nonweightbearing radiograph is shown for a patient with fracture dislocation of Lisfranc joint. Lateral partial incongruity of second tarsometatarsal joint was noted. (B) Postoperative AP radiograph shows well reduced Lisfranc joint with multiple screws. (C) All screws are removed. Lisfranc joint shows good congruity.

Reference

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