Percutaneous Treatment With Bridge Plate and Extra-articular Screws in Low-Energy and High-Energy Lisfranc Injuries

Abstract

Although there is no consensus regarding surgical treatment of unstable sprains and fractures dislocations of the Lisfranc complex, both anatomic reduction, proper alignment and adequate stabilization of the tarsometatarsal columns are essential when looking for good results. With the advent of minimally invasive surgery, and bearing in mind that the percentages of complications and sequelae despite the good results in reduction quality are still important, we aim to show the clinical and radiographic results over 1-year follow-up obtained by indirect reduction and percutaneous fixation with bridge plate and extra-articular screws in a series of patients with low-energy and high-energy Lisfranc lesions. Eleven patients were operated upon diagnosed with acute tarsometatarsal joint injuries, which showed unstable sprains and/or fracture dislocation with partial articular fracture and a minimum of 1-year follow up. The average age was 30.7 years. The results of the postoperative tomographic controls were as follows: residual joint step average of 0.2 mm, 0.45, and 0 mm in first cuneiform-base of first metatarsal, second cuneiform-base of second metatarsal and third cuneiform-base of third metatarsal, respectively. Anatomical reduction was obtained in the majority of our patients with very good functional results in the evaluated period. Although this is an ongoing investigation, we believe that this method could be taken into account in properly selected patients, even in high-energy injuries. Level of Evidence: Diagnostic Level IV. See Instructions for Authors for a complete description of levels of evidence.