Lisfranc fracture dislocation treatment [Tratamento da fratura-luxacao de Lisfranc]

Abstract

Between 1990 and 1997, twelve patients with Lisfranc fracture dislocations, submitted to an orthopedic treatment, were evaluated at Taubate's University Hospital. Patients were predominantly male in a proportion of 11:1. With respect to the traumatism action mechanism, there was a larger prevail of the indirect mode above the direct (8:4). The authors obtained ten close fracture dislocations and two open. The service adopted the Quenu and Kuss classification modified by Hardcastle, who emphasized the type of traumatism action mechanism, obtaining three cases of type A (totally incongruent), five cases of type B (partially incongruent) and four cases of type C (divergent). The treatment consisted of close reduction plus gypsum (one case), close reduction plus percutaneous fixation (six cases), and open reduction plus fixation (five cases). Results were considered good in two cases, regular in seven cases, and poor in three cases. The authors concluded that percutaneous fixation with Kirschner wire can be performed, as long as the open reduction is anatomic. In cases with little joint dislocation, the open reduction plus fixation may present better results over the long term.