The Clinical Analysis Of Lisfranc Injury

Background: Tarsalmetatarsal joint is also called Lisfranc joint.It is important to the stability of the midfoot. Lisfranc joint transmits the loads from the forefoot to the postpede and supports the weight in any stage of the gaits.Once it suffers injuries, the foot would lost most functions.However, it often missed.So early diagnosis and proper treatment are neccesary for a good outcome.The objective of the study is to get the best clinical method of Lisfranc injuries through the analysis of 22 patients who used to be treated in our hospital.Meterials and Methods: There were 22 patients with Lisfranc injuries who were treated in our hospital were enrolled in the retrospective study.All patients were followed for an average of 45 months .Evaluation was performed with the American Orthopaedic Foot and Ankle Society (AOFAS) Midfoot Scale.Patients were divided into groups in accordance with results of discharge and final follow-up results, the influence of treatment time on prognosis, conservative treatment and surgical treatment on the prognosis, and the integrity of the Lisfranc ligament on the prognosis respectively.All the results were analyzed statistically.Results: The final follow-up of 22 patients is stated below: excellent: 2 cases, good in 3 cases, can be 9 cases, poor in 8 cases. The average AOFAS score is 56.2 points. Overall acceptability rate was 59.1%. The acceptable rate of hospital discharge was 90.9%;however,the acceptance rate of the final results of the follow-up was just 63.6% (p<0.05); the acceptable rate of the early treatment group was 76.5%, and the acceptable rate of the late treatment group was 20% (p<0.05); the conservative treatment group acceptable rate of 20%, and the acceptable rate of surgical treatment group was 76.5% (p<0.05); the acceptable rate of the group which had intact Lisfranc ligaments was 81.3%,and the rate of the other was 16.7%(p<0.05).Conclusions: Following conclusions were drawn from the study .1)Early diagnosis and proper treatment is important to the prognosis.2)Once it got any image change, surgery treatment was recommended.3)The proper surgery time is within 24 hours after injury,or after 5-7 days when the foot edema is eliminated.4)The rigid anatomic reduction and firm fixation is the basis for a good prognosis,and the repair of the Lisfranc ligament should be valued.5)If the soft tissue was good,the first choice of the internal fixator should be plates,and the second choice should be screws and K-wires.6) Open reduction and internal fixation should be as the regular treatment.Arthrodesis should be as a salvage surgery.If the joint complex was crushed seriously, a primary stable arthrodesis of the medial two or three rays should be operated.