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
ARTICLE HIGHLIGHTS
Research background

In the clinic, the incidence of Lisfranc injury is not high but the rate of missed diagnosis is high, especially for occult and atypical injuries. The definition, diagnosis and treatment criteria of such injuries remain controversial.

Research motivation

A new concept "atypical Lisfranc joint complex injury" is introduced in this study.

Research objectives

We hope that the introduction of such a new concept can prompt clinicians to pay attention to such injuries and that this study can make some contributions to further standardize the diagnosis and treatment of this type of injury.

Research methods

This study used computed tomography and stress tests to diagnose and evaluate atypical Lisfranc joint complex injury, and active open reduction and internal fixation were performed to evaluate patients with joint instability.

Research results

In this retrospective analysis of 18 cases with atypical Lisfranc joint complex injury, the rate of excellent and good treatment reached 88.9%.

Research conclusions

In this study, a new classification method was used to study the case data which proved that the classification method has good clinical utility for such injuries. From this study, it is concluded that atypical Lisfranc joint complex injury is newly defined and included in Lisfranc injuries, but the classification, surgical indications and treatment strategies for this type of injury require further study. The number of columns involved in the Lisfranc joint complex injury was related to the degree of violence, but the prognosis of the injury was not necessarily directly related to the severity of the injury.

Research perspectives

Combining these results with those of other studies, we believe that anatomical reduction and stable fixation are the key factors in determining prognosis.