[Surgical treatment of tarsometatarsal joint complex injury]

To report the outcome of surgical treatment of tarsometatarsal joint complex injury.

In the period from January 2003 to December 2008, 167 cases of closed tarsometatarsal joint injury were treated, including 35 cases of tarsometatarsal joint complex injury. Diagnosis was made by X-ray examination or/and CT scan. Either close or open reduction was performed and followed by internal fixation with screw or/and plate. X-ray examination was done in the regular follow-up and functional evaluation was carried out by AOFAS midfoot score system.

In this series 135 cases got a mean follow-up of 48 months, ranging from 12 to 75 months. Therein the 26 cases of tarsometatarsal joint complex injury had a mean postoperative AOFAS midfoot score of 67 (ranging from 48 to 75), and secondary post-traumatic arthritis in 16 cases, 12 of which had arthrodesis as a result of severe pain. The 109 cases of pure tarsometatarsal joint injury had a mean postoperative AOFAS midfoot score of 82 (ranging from 70 to 95), and secondary post-traumatic arthritis in 17 cases, only 5 of which had arthrodesis finally. Those cases of pure tarsometatarsal joint injury treated by close reduction and internal fixation with percutaneous screw got a mean postoperative AOFAS midfoot score of 87 (ranging from 82 to 95), demonstrating a significant deference (t = 2.651, P < 0.05) when compared with that of metatarsal joint complex injury.

The tarsometatarsal joint complex injury has a prognosis inferior to that of the pure tarsometatarsal joint injury, and the keys to its successful treatment are appropriate diagnosis, anatomical reduction and secure fixation of all the components of the complex.