Case Reports| Volume 57, ISSUE 4, P794-800, July 2018

Surgical Treatment of Lisfranc Injury With Plantar Plate Approach

Published:April 11, 2018DOI:


      Midfoot injuries are the second most common athletic foot injury documented in the published data. High-energy Lisfranc dislocations are commonly seen secondary to traumatic etiologies and disrupt the strong midfoot ligaments supporting the arch. These injuries require immediate surgical intervention to prevent serious complications such as compartment syndrome and amputation. The present case series reports a new Lapidus plate system used in 3 patients who underwent arthrodesis procedures for Lisfranc joint dislocation. Three patients in their fourth to fifth decade of life presented with a traumatic injury at the Lisfranc joint and subsequently underwent open reduction and internal fixation using the plantar Lapidus Plate System (LPS; Arthrex, Naples, FL). The LPS was placed in a predetermined safe zone, with measures taken to avoid the insertional points of the tibialis anterior and peroneus longus tendons. Radiographs were obtained for ≤6 months postoperatively and revealed consolidation across the fusion site, intact hardware, and satisfactory alignment. On examination, the corrections were well maintained and free of signs of infection. Clinical evaluation showed no indication of motion within the tarsometatarsal joint and no tenderness to palpation surrounding the fusion sites. All 3 patients successfully returned to their activities of daily living without discomfort or pain. Modern surgical treatment of Lisfranc injuries most commonly includes open reduction and internal fixation, accompanied by arthrodesis. The present case series has demonstrated that the LPS provides relief, stability, and compression of the joint in our small cohort of patients who experienced a traumatic injury to the Lisfranc joint.

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        • Crates J.M.
        • Barber F.A.
        • Sanders E.J.
        Subtle Lisfranc subluxation: results of operative and nonoperative treatment.
        J Foot Ankle Surg. 2015; 54: 350-355
        • Scolaro J.
        • Ahn J.
        • Mehta S.
        Lisfranc fracture dislocations.
        Clin Orthop Relat Res. 2011; 469: 2078-2080
        • Desmond E.A.
        • Chou L.B.
        Current concepts review: Lisfranc injuries.
        Foot Ankle Int. 2006; 27: 653-660
        • Smith N.
        • Stone C.
        • Furey A.
        Does open reduction and internal fixation versus primary arthrodesis improve patient outcomes for Lisfranc trauma? A systematic review and meta-analysis.
        Clin Orthop Relat Res. 2016; 474: 1445-1452
        • Thompson M.C.
        • Mormino M.A.
        Injury to the tarsometatarsal joint complex.
        J Am Acad Orthop Surg. 2003; 11: 260-267
        • Ly T.V.
        • Coetzee J.C.
        Treatment of primarily ligamentous Lisfranc joint injuries: primary arthrodesis compared with open reduction and internal fixation.
        J Bone Joint Surg Am. 2006; 88: 514-520
        • Watson T.S.
        • Shurnas P.S.
        • Denker J.
        Treatment of Lisfranc joint injury: current concepts.
        J Am Acad Orthop Surg. 2010; 18: 718-728
        • Alberta F.G.
        • Aronow M.S.
        • Barrero M.
        • Diaz-Doran V.
        • Sullivan R.J.
        • Adams D.J.
        Ligamentous Lisfranc joint injuries: a biomechanical comparison of dorsal plate and transarticular screw fixation.
        Foot Ankle Int. 2005; 26: 462-473
        • Klos K.
        • Gueorguiev B.
        • Mückley T.
        • Fröber R.
        • Hofmann G.O.
        • Schwieger K.
        • Windolf M.
        Stability of medial locking plate and compression screw versus two crossed screws for Lapidus arthrodesis.
        Foot Ankle Int. 2010; 31: 158-163
        • Plaass C.
        • Claassen L.
        • Daniilidis K.
        • Fumy M.
        • Stukenborg-Colsman C.
        • Schmiedl A.
        • Ettinger S.
        Placement of plantar plates for Lapidus arthrodesis: anatomical considerations.
        Foot Ankle Int. 2016; 37: 427-432
        • Klos K.
        • Simons P.
        • Hajduk A.S.
        • Hoffmeier K.L.
        • Gras F.
        • Fröber R.
        • Hofmann G.O.
        • Mückley T.
        Plantar versus dorsomedial locked plating for Lapidus arthrodesis: a biomechanical comparison.
        Foot Ankle Int. 2011; 32: 1081-1085
        • Scranton P.E.
        • Coetzee J.C.
        • Carreira D.
        Arthrodesis of the first metatarsocuneiform joint: a comparative study of fixation methods.
        Foot Ankle Int. 2009; 30: 341-345
        • Lee C.A.
        • Birkedal J.P.
        • Dickerson E.A.
        • Vieta P.A.
        • Webb L.X.
        • Teasdall R.D.
        Stabilization of Lisfranc joint injuries: a biomechanical study.
        Foot Ankle Int. 2004; 25: 365-370
        • Hsu A.
        • Moss L.
        • Harris T.G.
        Dorsal plating of low-energy Lisfranc injuries: a case report.
        Foot Ankle Spec. 2015; 8: 73-76