Retrospective Study
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Oct 6, 2020; 8(19): 4388-4399
Published online Oct 6, 2020. doi: 10.12998/wjcc.v8.i19.4388
Clinical study on the surgical treatment of atypical Lisfranc joint complex injury
Xu Li, Le-Sheng Jia, Ang Li, Xin Xie, Jun Cui, Guo-Liang Li
Xu Li, Le-Sheng Jia, Ang Li, Jun Cui, Guo-Liang Li, Department of Foot and Ankle Surgery, Central Hospital Affiliated to Shenyang Medical College, Shenyang 110024, Liaoning Province, China
Xin Xie, Department of Functional Experiment Center, Liaoning University of Traditional Chinese Medicine, Shenyang 110847, Liaoning Province, China
Author contributions: Li X designed, performed and wrote the paper on the research; Li GL contributed to the research design and supervised the report; Jia LS, Li A and Cui J provided clinical advice and supervised the report; Xie X designed the research and contributed to the analysis.
Supported by Science Foundation of Shenyang Medical College, No. 20187076.
Institutional review board statement: This study was reviewed and approved by The Ethics Committee of Central Hospital affiliated to Shenyang Medical College.
Informed consent statement: All study participants or their legal guardians consented by signing a written document prior to study enrollment.
Conflict-of-interest statement: This research was not affected by external sources being it personal, commercial, political, intellectual or religious interests.
Data sharing statement: No additional data available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Guo-Liang Li, MD, Chief Doctor, Professor, Department of Foot and Ankle Surgery, Central Hospital Affiliated to Shenyang Medical College, No. 5 7th Road, Tiexi District, Shenyang 110024, Liaoning Province, China. 398101842@qq.com
Received: May 10, 2020
Peer-review started: May 10, 2020
First decision: June 7, 2020
Revised: June 20, 2020
Accepted: August 22, 2020
Article in press: August 22, 2020
Published online: October 6, 2020
Processing time: 140 Days and 13.5 Hours
Abstract
BACKGROUND

Lisfranc injuries have not received much attention by orthopedic doctors in the past, and there is little related research on the diagnosis and treatment of these injuries. In recent years with the rise in foot and ankle surgery, doctors are now paying more attention to this type of injury. However, there is still a high rate of missed diagnosis due to insufficient attention causing treatment delays or inadequate treatments, which eventually result in greater sequelae; including long-term pain, arthritis, foot deformity etc. In particular, for cases with a mild Lisfranc joint complex injury, the incidence of sequelae is higher.

AIM

To select an active surgical treatment for an atypical Lisfranc joint complex injury and to evaluate the clinical efficacy of the surgical treatment.

METHODS

The clinical data of 18 patients, including 10 males and 8 females aged 20-64 years with Lisfranc injuries treated in our department from January 2017 to September 2019 were retrospectively analyzed. All patients were treated with an open reduction and internal fixation method using locking titanium mini-plates and hollow screws or Kirschner wires. X-ray images were taken and follow-up was performed monthly after the operation; the internal fixation was then removed 4-5 mo after the operation; and the American Orthopedic Foot and Ankle Society (AOFAS) score was used for evaluation on the last follow-up.

RESULTS

All patients were followed up for 6-12 mo. A good/excellent AOFAS score was observed in 88.9% of patients.

CONCLUSION

For atypical Lisfranc joint complex injuries, active open reduction and internal fixation can be performed to enable patients to obtain a good prognosis and satisfactory functional recovery.

Keywords: Lisfranc joint complex injury; Avulsion fracture; Open reduction and internal fixation; Atypical Lisfranc injury; Stress test; Computed tomography

Core Tip: This retrospective study evaluated the efficacy of open reduction and internal fixation for atypical Lisfranc joint complex injuries. The new concept of "atypical Lisfranc joint complex injury" was introduced and defined. A novel classification system was also introduced and its practicability determined. Based on this study, it was concluded that open reduction and internal fixation are effective for the treatment of "atypical Lisfranc joint complex injury" and the new classification system had good clinical practicability.