TITLE:
Fracture-Dislocations of Lisfranc Joint in Lomé (Togo)
AUTHORS:
Atchi Walla, Anani Abalo, Agbékponou Lagnéblé, Sényo Tsolenyanu, Tchaa Towoezim, N. K. Kombaté, Michel Assang Dossim
KEYWORDS:
Dislocation, Fracture, Lisfranc Joint, Pinning
JOURNAL NAME:
Open Journal of Orthopedics,
Vol.6 No.1,
January
29,
2016
ABSTRACT: Introduction: The purpose
of this prospective study was to describe the clinic pathological varieties of fracture-dislocations
of Lisfranc joint and outcome of treatment. Patients
and Methods: This study was conducted on 21 cases of fracture-dislocations of
the Lisfranc joint treated in our orthopedics trauma unit from 2010 to 2013. We
selected middle foot pure dislocations or associated with Lisfranc joint bone
fractures. Classification of Myerson was used to characterize the lesions. The results
assessment criteria were clinical and radiological for foot and Massari score. Results: Fourteen (14) patients were male.
The average age was 34.7 years. Five (5) clinic pathological forms were met by relying on the classification
of Myerson; 4 cases of type A; 5 cases of type B1; B2, 6 cases; 4 cases of type
C1 and 2 cases of type C2. There were eight cases of pure dislocation and 13 dislocations
were associated with fractures (metatarsal in 11 patients, cuneiform in 5 patients,
cuboid bone in 2 patients and enucleation fracture of the medial cuneiform in 2
patients). It was noted 10 cases of skin openings. Treatment consisted on open reduction
in all patients and stabilization by pin complemented by a foot plaster for 6 weeks.
Four (4) immediately arthrodeses were made. All patients were followed up 7 month
to 4 years (mean, 30 month). According to the criteria of Massiri, treatment outcomes
were excellent in 19% of cases, good in 28%, fair in 30% and poor in 23%. Conclusion: In our context, these lesions
are often open and associated with fractures of Lisfranc joint skeleton and treated
after a period more or less long and sometimes, we face lesions totally old. Immediately
arthrodesis can be a lasting solution and should not be overlooked.