Reconstruction After Malunited Lisfranc Injuries

Area of Science:

• Orthopedic Surgery
• Podiatric Medicine
• Biomechanics

Background:

• Lisfranc joint malunions, often from missed injuries, cause secondary osteoarthritis, pain, and functional loss.
• These conditions significantly disrupt walking performance and may be misdiagnosed as neuro-osteoarthropathic disorders.
• Multiplanar deformities can accompany secondary osteoarthritis in the Lisfranc joint.

Purpose of the Study:

• To outline a standardized approach for diagnosing and surgically managing Lisfranc joint malunions.
• To describe a corrective arthrodesis concept focused on restoring foot column alignment and proportions.
• To evaluate the efficacy of limited fusion in treating symptomatic secondary osteoarthritis of the Lisfranc joint.

Main Methods:

• Clinical assessment and pathomorphological analysis to guide surgical planning.
• Surgical intervention involving corrective arthrodesis with attention to multiplanar deformity.
• Specific technique: fusion limited to the medial three rays combined with soft tissue release.

Main Results:

• A comprehensive surgical concept respecting deformity realignment is crucial for functional outcomes.
• A fusion limited to the medial three rays with soft tissue release can achieve favorable results in most cases.
• This approach preserves the mobility of the two lateral rays, contributing to better function.

Conclusions:

• Accurate diagnosis and a tailored surgical strategy are essential for managing Lisfranc joint malunions.
• Limited arthrodesis of the medial Lisfranc rays is an effective treatment for secondary osteoarthritis.
• Preserving lateral ray mobility enhances functional recovery and patient satisfaction.