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Tarsometatarsal fractures and dislocations.
R Pérez Blanco1, C Rodríguez Merchán, R Canosa Sevillano
1Department of Orthopaedic Surgery, La Paz Hospital, University Autónoma, Madrid, Spain.
Journal of Orthopaedic Trauma
|January 1, 1988
Summary
This study reviewed 32 tarsometatarsal fracture dislocations, finding that accurate reduction is key for good outcomes. Routine Kirschner (K)-wire fixation is recommended for all cases of these foot injuries.
Area of Science:
- Orthopedic Surgery
- Traumatology
- Podiatric Medicine
Background:
- Tarsometatarsal fracture dislocations are complex foot injuries.
- Accurate classification and treatment are crucial for patient outcomes.
- Previous studies highlight varied results and treatment approaches.
Purpose of the Study:
- To retrospectively review outcomes of tarsometatarsal fracture dislocations.
- To evaluate the effectiveness of different treatment methods.
- To identify factors associated with successful treatment outcomes.
Main Methods:
- Retrospective review of 32 cases over 15 years.
- Classification using Quénu and Küss' system.
- Treatment included closed or open reduction, with optional Kirschner (K)-wire fixation.
- Outcomes assessed using Hardcastle's scoring system.
Main Results:
- 29 patients evaluated with a mean follow-up of 6.3 years.
- Most dislocations were partial (21/32).
- 20 good, 5 fair, and 3 poor results were achieved.
- Accurate reduction correlated with good outcomes.
- One early amputation occurred.
Conclusions:
- Accurate reduction is the most critical factor for successful treatment of tarsometatarsal fracture dislocations.
- Open reduction is advised for persistent minor displacement.
- Routine Kirschner (K)-wire fixation is recommended for all cases to ensure stability and optimize healing.