J Korean Fract Soc.  1996 Jul;9(3):725-732.

Treatment of the Tarsometatarsal Joint Fracture-Dislocation

• Lee KY
• Lee YK
• Cho YM
• Kang HS

Abstract

Traumatic dislocation and fracture-dislocation of the tarsometatarsal joint rare injuries. These injuries often missed because radiographs of this joint is difficult to be interpreted, so delay to be diagnosed and treated. These injuries often leads to arthritic change with significant residual symptoms and deformities. Tarsometatarsal joint injuries are generally managed by accurate repositioning of the displaced metatarsals and stabilization with instruments(K-wire, screws etc.). The purpose of this study is to review the anatomical, radiological and functional results. The authors analysed the 25 cases with injuries of the tarsometatarsal joint treated of the department of Orthopaedic Surgery, Lee-Rha general hospital from March 1989 to September 1994, which showed the following results. 1. The most common cause of the injury was traffic accident(76%). 2. According to the Hardcastles classification, the injuries were classified as follows:partial incongruity in 16 cases(64%), total incongruity in 6 cases(24%), and divergent congruity in 3 cases(12%). 3. Three cases were treated with closed reduction and case immobilization, thirteen cases were treated with closed reduction and percutaneous K-wire fixation. Nine cases were treated with open reduction and K-wire fixation as follows:reduction failure in 3 cases, entrapment of anterior tibial tendon in 2 cases, severe soft tissue injury in 4 cases. 4. The anatomic reduction and its maintenance were considered as most important factor of prognosis.

Keyword

Fracture-dislocation of the tarsometatarsal joint; Anatomical reduction

MeSH Terms

Classification
Congenital Abnormalities
Dislocations
Hospitals, General
Immobilization
Joints*
Metatarsal Bones
Prognosis
Soft Tissue Injuries
Tendons