Original scientific paper
Injuries of the Tarsometatarsal Joints: Treatment and Outcome
Mario Malović
Milan Milošević
Tomislav Vlahović
Tatjana Nikolić
Petra Margetić
Milan Milošević
Abstract
Between January 2005 and May 2009, a total of 26 patients, 21 males and 5 females, were admitted for treatment of
Lisfranc lesion. All patients were radiologically evaluated and classified according to the criteria proposed by Myerson: 5
(19.2%) patients had a type A injury, 2 patients (7.7%) presented with a type B1 injury, 17 (65.4%) sustained the most
common type B2 injury and 1 (3.8%) patient suffered from a type C1 and C2 injury. Taking radiological and clinical
findings in account, fifteen patients were elected for operative treatment and eleven patients were treated conservatively.
According to type of fracture we established three groups; in group I metatarsal fracture was found in fourteen (53.9%)
patients, group II with phalangeal fracture in three (11.5%) cases, whereas in group III nine (34.6%) patients sustained
combined metatarsal, navicular and, most commonly, a cuneiform fracture.Using the American Orthopedic Foot and
Ankle Society (AOFAS) midfoot scoring scale and SF-36 questionnaire, the functional outcome was assessed. The mean
value for age distribution was 42.7±13.2 years and the mean follow up was 27.9±12.4 months. A p value <0.005 was regarded
as statistically significant for the analysis of the results. We found by means of SF 36 questionnaire a statistically
significant difference in the role limitation due to existence of pain (p=0.04) and poor general health (p= 0.013) in the
group of patients that sustained combined foot fracture. The purpose of this study is to assess the treatment of Lisfranc
injuries in our patients, according to SF 36 and AOFAS criteria, clinical outcome was evaluated. In the group I the mean
AOFAS score was 74.0±9.1 and in the group II it reached 72.0±5.2 signifyng fair outcome! Poor outcome was present in
the group III with mean AOFAS score 67.1±9.0. All unstable injuries require surgery. Clinical outcome is highly dependent
on the restoration of normal anatomic alignment.
Keywords
tarsometatarsal injury; dislocation; clinical outcome
Hrčak ID:
75639
URI
Publication date:
30.12.2011.
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