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Severe open Lisfranc injuries: one-stage operation through internal fixation associated with vacuum sealing drainage
Wenqing Qu1, Shuqin Ni1, Zhenhai Wang1
1Department of Orthopaedics and Trauma, Yantaishan Hospital, Yantai, 264008, China.
Background:
This study aimed to investigate the clinical feasibility of treating severe open Lisfranc injuries by means of one-stage internal fixation with k-wires associated with vacuum sealing drainage (VSD).
Methods:
The clinical outcomes of 20 cases of severe open Lisfranc joint fracture-dislocation treated by using one-stage internal fixation with k-wires associated with VSD, after debridement and suturing during emergency treatment, were reviewed.
Results:
At 6 and 12 months after surgery, the American Orthopaedic Foot and Ankle Society midfoot scores were 69.2 and 78.2, the positive rates were 75 and 85 %, and the average visual analogue scale scores were 4.3 and 1.3, respectively. The average time of internal fixation surgery was 47 min (30-70 min). There were three cases of wound-edge necrosis; however, there were no cases of skin necrosis around the incision, or deep infection. The mean time of first hospital stay was 16.1 days (10-23 days).
Conclusions:
Treatment of severe open Lisfranc fracture and dislocation through one-stage internal fixation with k-wires in association with VSD led to fast anatomical reduction, stabilized bony structure, fast soft tissue recovery, and good short-term follow-up results.
