Surgical treatment of Lisfranc injuries involving the navicular,cuneiform or navicular-cuneiform joints
Objective:To investigate the characteristics and treatment modalities of Lisfranc injuries involving the navicular,cuneiform or navicular-cuneiform joints.Methods:A retrospective analysis was conducted on the clinical data of 14 patients with Lisfranc injuries admitted from November 2017 to November 2022.This cohort included 9 males and 5 females,aged between 22 and 58 years,with a mean age of(35.6±8.7)years.The injuries included 5 cases of navicular-cuneiform joint dislocation,3 cases of navicular fracture,and 6 cases of medial cuneiform fracture.All patients underwent open reduction and internal fixation.Postoperative complications such as incision infection,foot pain,or sensory numbness were observed.Pain visual analogue scale(VAS)scores were recorded preoperatively and at the final follow-up,and foot function was assessed using the American Orthopedic Foot and Ankle Society(AOFAS)midfoot score at the final follow-up.Results:The 14 patients were followed up for 4 to 53 months,with an average follow-up period of 22.5(14.5,32.0)months.Only one patient experienced numbness on the dorsum of the foot postoperatively,and no other surgical complications occurred in the remaining patients.At the final follow-up,the pain VAS score 1.5(1.0,2.0)was significantly lower than the preoperative score(7.4±0.8)(U=0,P＜0.05).The AOFAS score at the final follow-up reached(75.4±10.3),indicating significant recovery of motor function and notably reduced pain upon weight bearing.Conclusions:Lisfranc injuries involving the navicular,cuneiform or navicular-cuneiform joints differ from traditional Lisfranc injuries involving the first metatarsocuneiform joint.Treatment should be based on the direction of the injury force to determine the starting point of the injury,thus developing a specific surgical plan to avoid missing injured areas that may affect the prognosis.
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