Rigid Stabilization of Partial Incongruous Lisfranc Dislocations: A Cannulated Solid Screw Technique

Abstract

1 , Dekarlos M. Dial, DPM 2 The Foot and Ankle Online Journal 2 (6): 4 For several years, there has been much controversy over the optimal form of fixation in the operative treatment of Lisfranc injuries. Both cortical and cannulated screws have been widely used in the treatment of these injuries. The level of technical difficulty and reproducible accuracy of the cannulated screw system has gained much popularity. In comparison, the rigid stability of cortical screws appears more favorable. The authors present a cannulated technique utilizing a single 4.0 mm cortical screw (Synthes USA Paoli, Pa.). In Lisfranc injuries with partial incongruity, this method allows precise screw placement while maintaining rigid solid screw stabilization. The technique is minimally invasive, provides anatomical restoration and allows early return to functional activity. This is an Open Access article distributed under the terms of the Creative Commons Attribution License. It permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. ©The Foot and Ankle Online Journal (www.faoj.org) isfranc fracture dislocations account for 0.2 % of all fractures. 1,2 In 1909, Quenu and Kuss described the first classification system for Lisfranc injuries. 3 This classification system was modified by Hardcastle in 1982. 2 In 1986, Myerson, et al., 5 further modified the Hardcastle classification into medial and lateral dislocations. Type A is a total incongruent tarsometatarsal joint complex. Types B1 is a partial incongruity with medical displacement affecting the first ray or first metatarsal, and B2 is partial incongruity resulting in lateral displacement of one or more lesser metatarsals. The most common Lisfranc injury in the athlete is the partial incongruous injury resulting in medial or lateral dislocation.