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Radiographic and computed tomographic evaluation of Lisfranc dislocation: a cadaver study
1Department of Orthopaedic Surgery, Medical College of Ohio, Toledo 43614, USA.
Foot & Ankle International
|June 1, 1997
Summary
Computed tomography (CT) scans are more sensitive than standard radiographs for detecting subtle Lisfranc injuries. Early CT evaluation aids in diagnosing occult joint subluxation, potentially preventing post-traumatic arthritis.
Area of Science:
- Orthopedics
- Radiology
- Medical Imaging
Background:
- Lisfranc injuries involve the tarsometatarsal joints.
- Occult subluxations can lead to unpredictable outcomes.
- Radiographs may miss subtle displacements.
Purpose of the Study:
- To compare the sensitivity of CT scans versus radiographs in detecting Lisfranc joint displacement.
- To evaluate the utility of CT in assessing minor Lisfranc injuries.
Main Methods:
- Six cadaver feet underwent simulated dorsolateral Lisfranc dislocations in 1-mm increments.
- Radiological and computed tomographic (CT) evaluations were performed on all specimens.
Main Results:
- CT scans detected all simulated Lisfranc dislocations, including 1-mm and 2-mm displacements.
- Routine radiographs failed to visualize 1-mm dislocations and two-thirds of 2-mm dislocations.
- CT provided better assessment of minor lesions obscured by overlapping structures on radiographs.
Conclusions:
- CT scanning is more sensitive than radiography for detecting subtle Lisfranc displacement.
- CT is recommended when radiographs are equivocal for Lisfranc injury.
- Early diagnosis and treatment of Lisfranc injuries may reduce the risk of degenerative arthritis.