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[Corrective tarsometatarsal arthrodesis for malunion after fracture-dislocation]
S Rammelt1, W Schneiders, H Zwipp
1Klinik und Poliklinik für Unfall- und Wiederherstellungschirurgie, Universitätsklinikum Carl Gustav Carus, Technische Universität, Dresden. strammelt@hotmail.com
Der Orthopade
|September 30, 2005
Summary
Malunited Lisfranc (tarsometatarsal) joint injuries cause painful deformities and functional loss. Corrective arthrodesis offers significant pain reduction and improved function, especially with anatomic realignment and limited fusion.
Area of Science:
- Orthopedic Surgery
- Podiatric Medicine
- Traumatology
Background:
- Malunited Lisfranc (tarsometatarsal) joint injuries frequently result in debilitating deformities and functional impairment.
- These malunions stem from missed or inadequately treated initial injuries, leading to forefoot abduction/adduction and planus/cavus deformities.
Purpose of the Study:
- To evaluate the efficacy of corrective arthrodesis for malunited Lisfranc joint injuries.
- To identify factors influencing outcomes and patient satisfaction following surgical correction.
Main Methods:
- Literature review of studies reporting on corrective tarsometatarsal arthrodesis for malunited injuries.
- Analysis of surgical techniques focusing on axial realignment and fusion strategies.
Main Results:
- Corrective tarsometatarsal arthrodesis consistently reduces pain and improves function.
- Patient satisfaction rates range from 69% to 100% in reviewed literature.
- Anatomic realignment and limited fusion (medial metatarsocuneiform joints) are favorable prognostic factors.
Conclusions:
- Corrective arthrodesis is an effective treatment for malunited Lisfranc joint injuries, yielding significant pain relief and functional gains.
- Limiting fusion to the medial metatarsocuneiform joints, when feasible for complete realignment, is associated with better outcomes.