Treatment of tarso-metatarsal joint injury

Objective:To evaluate the treatment methods and clinical effect of dislocation and fracture-dislocation of tarsometatarsal joint.Method:We performed a retrospective study of patients with Lisfranc injury in a seven-year period(1998-2004). Among seventy-four patients, twenty-four were treated with plaster fixation, twenty-two with Kirschner wire fixation and twenty-eight with screw fixation. Twenty-one injuries were purely ligamentous, and fifty-three were combined ligamentous and osseous.Result:Seventy-four patients were followed for an average of eighteen months.Patient outcome was assessed with the American Orthopedic Foot and Ankle Society (AOFAS) midfoot score. Conclusion:Anatomical reduction and screw fixation of a Lisfranc injury leads to the best long-term outcomes,but purely ligamentous injuries have poor outcomes despite surgical managements.