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Anatomical Pathology of Subtle Lisfranc Injury.
Scientific Reports ( IF 3.8 ) Pub Date : 2019-10-16 , DOI: 10.1038/s41598-019-51358-8
Naoki Haraguchi 1 , Koki Ota 2 , Takuma Ozeki 2 , Shingo Nishizaka 2
Affiliation  

The extent and patterns of Lisfranc joint complex disruption in subtle Lisfranc injuries have not been well clarified. We reviewed the direct intraoperative findings for 87 patients, examined computed tomography images that had been obtained preoperatively for 73 of the patients, and classified the injuries according to the Kaar et al. criteria as the transverse type (instability between the first cuneiform [C1] and the second metatarsal [M2] and between the second cuneiform [C2] and M2) or longitudinal type (instability between C1 and M2 and between C1 and C2). Our patients' injuries were classified as follows: longitudinal type (38%), transverse type (30%), transverse type and first tarsometatarsal (TMT) joint injury (20%), longitudinal type plus transverse type (7%), longitudinal type and first TMT joint injury (3%), and longitudinal type, transverse type, and first TMT joint injury (2%). In 11 patients, the longitudinal injury extended into the naviculo-first cuneiform joint. In 41 (56%) of the 73 patients for whom CT images were obtained, 1 or more fractures (not counting small avulsion fragments between C1 and M2) were found. Orthopedic surgeons should be aware of the various injury patterns possible in cases of subtle Lisfranc injury.

中文翻译:

微妙的Lisfranc损伤的解剖病理学。

Lisfranc关节复合体在细微的Lisfranc损伤中破裂的程度和方式尚未得到很好的阐明。我们回顾了87例患者的直接术中发现,检查了73例患者术前获得的计算机断层扫描图像,并根据Kaar等对损伤进行了分类。标准为横向类型(第一楔形[C1]和第二meta骨[M2]之间以及第二楔形[C2]和M2之间的不稳定性)或纵向类型(C1和M2之间以及C1和C2之间的不稳定性)。我们的患者受伤分为以下类型:纵向型(38%),横向型(30%),横向型和第一骨(TMT)关节损伤(20%),纵向型加横向型(7%),纵向型以及第一次TMT关节损伤(3%)和纵向型,横向型和首次TMT关节损伤(2%)。在11例患者中,纵向损伤扩展到了鼻-头楔形关节。在获得CT图像的73例患者中,有41例(56%)发现了1个或更多的骨折(不包括C1和M2之间的小撕脱碎片)。矫形外科医生应注意轻微的Lisfranc损伤情况下可能发生的各种损伤类型。
更新日期:2019-10-17
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