Dorsomedial bridge plating of lisfranc injuries

Research output: Contribution to journalArticle

12 Scopus citations

Abstract

Injuries to the tarsometatarsal joints remain uncommon, with a reported incidence of 1 per 55,000 people per year. Lisfranc injuries make up a small percentage of all fractures, though the incidence appears to be increasing. Although the criteria for surgical intervention are well accepted, a significant controversy exists regarding surgical technique. This becomes increasingly cloudy as the debate moves from complex fractures to purely ligamentous injuries. Although pure ligamentous injuries have traditionally been fixed with Kirschner wires or screws transfixing the involved joints, a recent prospective, randomized study suggests that these injuries may be best treated by primary arthrodesis. The goal of any surgery addressing a Lisfranc injury is not only to restore the patient's anatomy, but also to preserve the involved joints. There are numerous studies implicating both heat and traumatic impact as sources of cell-mediated chondrocyte death. Transarticular screw placement requires drilling across an intact cartilage layer that has already sustained traumatic insult. This "second hit" may exacerbate an already complicated problem, and, potentially, accelerate the posttraumatic arthritic process. Extra-articular bridge plate fixation offers a means of addressing these Lisfranc injuries without joint violation.

Original languageEnglish (US)
Pages (from-to)215-220
Number of pages6
JournalTechniques in Foot and Ankle Surgery
Volume8
Issue number4
DOIs
StatePublished - Dec 1 2009

Keywords

  • Dorsomedial bridge plating
  • Extraarticular bride plate fixation
  • Lisfranc injuries
  • Transarticular screw placement

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine
  • Surgery

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