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Ankle Joint01:10

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The ankle is formed by the talocrural joint (crural = leg). It consists of the articulations between the talus bone of the foot and the distal ends of the tibia and fibula of the leg. The superior aspect of the talus bone is square-shaped and has three areas of articulation. The top of the talus articulates with the inferior tibia. This is the portion of the ankle joint that carries the body weight between the leg and foot. The sides of the talus are firmly held in position by the articulations...
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Treatment for a fracture is based on the type of break, the bone affected, and the patient's age.
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Management of Tarsometatarsal Joint Injuries.

Brian M Weatherford1, John G Anderson, Donald R Bohay

  • 1From the Illinois Bone and Joint Institute, Glenview, IL (Dr. Weatherford) and Orthopaedic Associates of Michigan, Grand Rapids, MI (Dr. Anderson and Dr. Bohay).

The Journal of the American Academy of Orthopaedic Surgeons
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Injuries to the tarsometatarsal (TMT) or Lisfranc joint range from sprains to crush injuries. Prompt diagnosis and treatment are crucial to prevent long-term pain and dysfunction.

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Area of Science:

  • Orthopedic Surgery
  • Sports Medicine
  • Podiatric Medicine

Background:

  • Tarsometatarsal (TMT) joint complex injuries, commonly known as Lisfranc injuries, encompass a range of pathologies.
  • Missed or delayed diagnosis can lead to chronic pain, dysfunction, posttraumatic arthritis, and arch collapse.

Purpose of the Study:

  • To outline the essential components for diagnosing and treating TMT joint injuries.
  • To discuss current management strategies, including nonoperative and operative interventions.

Main Methods:

  • Review of relevant anatomy, injury mechanisms, and physical examination techniques.
  • Discussion of appropriate imaging modalities for TMT joint assessment.
  • Analysis of indications and outcomes for nonoperative and surgical treatments.

Main Results:

  • Accurate diagnosis requires understanding TMT joint anatomy, injury mechanisms, and proper examination/imaging.
  • Nonoperative management is suitable for select patients with stable injuries.
  • Surgical treatment necessitates anatomic reduction and stable fixation, with ORIF as the standard and arthrodesis as an alternative.

Conclusions:

  • Comprehensive knowledge of TMT joint injuries is vital for effective patient management.
  • Tailored treatment approaches, considering injury severity and stability, optimize outcomes.
  • Open reduction and internal fixation (ORIF) remains the gold standard, while primary arthrodesis offers a viable alternative for specific cases.