Open Reduction and Fixation of Unstable Lisfranc Injuries Using Dorsal Plates

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Abstract

Injuries to the Lisfranc complex of the midfoot are a common problem that can have a considerable long-term morbidity. Anatomic reduction is paramount to giving the best opportunity for a successful result. Multiple options exist for fixation once anatomic reduction has been achieved, including Kirschner wires (K-wire), transarticular screws, dorsal plates, and suture-bridge devices. Although many studies stress the importance of anatomic reduction and stable fixation, few directly compare the different forms of fixation. Adequate evidence exists supporting the use of dorsal plates as a stable fixation device for anatomically reduced Lisfranc injuries. This paper discusses this option and reports on a small cohort of patients treated in this manner. Possible benefits of dorsal plates include direct visualization of the reduction and preservation of the tarsal-metatarsal joints. Potential undesirable consequences include hardware failure and soft tissue irritation. Early results indicate that dorsal plating seems to be a viable option as a fixation device for displaced Lisfranc injuries.

Level of Evidence: Diagnostic Level 4. See Instructions for Authors for a complete description of levels of evidence.

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