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Published on: February 17, 2018
Anatomical considerations for reconstruction of the Lisfranc ligament
Takaaki Hirano1, Hisateru Niki, Moroe Beppu
1Department of Orthopaedics Surgery, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae, Kawasaki, Kanagawa, ZIP 216-8511, Japan, takaaki.hirano@gmail.com.
Background:
The Lisfranc ligament is important in supporting the arch of the foot. Injury to this ligament causes pain and deformity of the foot.
Methods:
We studied the Lisfranc ligament and its surrounding anatomical structures in detail, and examined the route for reconstruction and the thickness of the ligament for optimum reconstruction. 78 feet of 39 cadavers were used for systematic dissection. Of the cadavers 17 were males and 22 were females; their ages ranged from 60 to 99 years (mean age 84.5 years).
Results:
The Lisfranc ligament is a fasciculated interosseous ligament that binds the lateral surface of C1 and the medial surface of M2. It has one to four fasciculi; the mean number of fasciculi is 2.0 and the cross-sectional area is 88 mm(2). The ideal reconstruction is such that the center of the ligament is positioned 5.9 mm distally from the C2-M2 joint surface on M2, and at a position 8.6 mm centrally from the C1-M1 joint surface on C1. The reconstruction would also be ideal if positioned at the same level as the C2-M2 joint surface on C1, horizontal to the plantar surface from the medial surface of C1 toward M2. This is the route for anatomical reconstruction of the Lisfranc ligament.
Conclusion:
Our results reveal some important aspects of anatomical and physiological ligament reconstruction.