Background
Lisfranc fracture dislocation is a devastating trauma affecting usually young active age group, with a high rate of missing or misdiagnosis, resulting in prolonged recovery and significant long-term morbidity.
Objective
This study describes the indications, contraindications, technique, and results of treating severe Lisfranc fracture dislocation by primary arthrodesis.
Patients and methods
A prospective study was conducted on 10 patients with closed Lisfranc fracture dislocation, who had been treated at Benha University Hospital and Benha Insurance Hospital between January 2010 and March 2013. Mechanism of injury was high-velocity injury in five patients, fall from a height in four patients, and a hyperplanterflexion foot trauma during descending stairs in one patient. Mean age at time of surgery was 27.7 years (range, 19–38 years). All patients were followed up with a follow-up period of 21.3 months (range, 6–36 months).
Results
According to the American Orthopedic Foot and Ankle Society scale, the clinical outcome was 81.7 (range, 79–84). Complications met in this study were as follows: three patients had a postoperative Sudeck’s atrophy, one patient developed superficial wound problem, and two patients had forefoot stiffness and difficulties in shoe wearing.
Conclusion
Open reduction and internal fixation of severe Lisfranc fracture dislocation with screws and primary arthrodesis is the treatment of choice, as these fracture dislocations are known for their affinity for post-traumatic arthritis and subsequent need for a second operation. The level of evidence for this article was case series type IV.