Correlation of Lisfranc Injuries With Regional Bone Density.

Area of Science:

• Orthopedic Surgery
• Radiology
• Biomechanics

Background:

• Lisfranc injuries are common yet frequently misdiagnosed.
• Limited data exists on the relationship between bone density and Lisfranc injury patterns.
• Computed tomography (CT) is crucial for diagnosing Lisfranc injuries.

Purpose of the Study:

• To compare regional bone density between different Lisfranc injury types.
• To investigate the association between bone density and concomitant fractures in Lisfranc injuries.
• To determine if bone density can aid in classifying Lisfranc injuries.

Main Methods:

• Retrospective review of 134 patients with Lisfranc injuries (avulsion vs. ligamentous).
• CT scans used to assess regional bone density via Hounsfield units (HU) in specific foot bones.
• Bone density compared between injury types and fracture patterns.

Main Results:

• Ligamentous Lisfranc injuries showed significantly higher bone density in the cuboid and talus compared to avulsion injuries.
• Patients with ligamentous injuries and concomitant mid/hindfoot fractures had greater bone density in most assessed bones.
• No significant differences in BMI, age, or smoking status were found between injury groups.

Conclusions:

• Increased regional bone density is associated with ligamentous Lisfranc injuries, especially when combined with mid/hindfoot fractures.
• Regional bone density analysis using CT-derived HU can be a valuable tool in foot and ankle trauma assessment.
• This study provides new insights into the biomechanical factors influencing Lisfranc injury severity.