J Korean Foot Ankle Soc.  2020 Dec;24(4):165-167. 10.14193/jkfas.2020.24.4.165.

Freer Test for an Intraoperative Evaluation of a Lisfranc Joint Injury: A Technical Report

• Young KW
• Lee HS
• Park S
• Jeong GM

• KMID: 2509539
• DOI: http://doi.org/10.14193/jkfas.2020.24.4.165

Abstract

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.

Keyword

Metatarsus; Metatarsal bones; Surgery

Figure

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  Fig. 1 The Freer elevator is inserted into the interosseous area between the medial cuneiform and the second metatarsal.

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  Fig. 2 A twisting force is applied to the Freer elevator, attempting to separate the first and second metatarsals.

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  Fig. 3 A twisting force is applied to the Freer elevator to check for stability after redudction with bone reduction forceps.

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  Fig. 4 After fixation of the Lisfranc joint, the stability of the fixation can be tested by trying the twisting motion with the inserted Freer elevator.

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