Cargando…

Staged management of open Lisfranc injury: Experience from 14 patients

There are still controversies on the management and outcome of open Lisfranc injury in available studies. This study evaluates the staged management of Lisfranc injury and its complications. Patients who received a staged strategy for open Lisfranc injury were reviewed. One patient with degloving in...

Descripción completa

Detalles Bibliográficos
Autores principales: Gu, Wenqi, Shi, Zhongmin
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer Health 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5413238/
https://www.ncbi.nlm.nih.gov/pubmed/28445273
http://dx.doi.org/10.1097/MD.0000000000006699
_version_ 1783233147516747776
author Gu, Wenqi
Shi, Zhongmin
author_facet Gu, Wenqi
Shi, Zhongmin
author_sort Gu, Wenqi
collection PubMed
description There are still controversies on the management and outcome of open Lisfranc injury in available studies. This study evaluates the staged management of Lisfranc injury and its complications. Patients who received a staged strategy for open Lisfranc injury were reviewed. One patient with degloving injury suffered from partial skin and hallux necrosis which was treated by debridement, hallux amputation, definitive internal fixation, and local flap transfer on the 12th day after first stage management. A definitive internal fixation and simultaneous skin graft or flap coverage were performed in another 3 patients with soft tissue defects. Other patients without soft tissue problems underwent a second stage of definitive internal fixation. Bone union was observed on the 12.5th week after definitive surgery. The median AOFAS midfoot score at the last follow-up was 74.4 ± 8.7, while the average VAS score was 2.2 ± 1.8. The average return-to-work time was 8th months postoperatively in 9 patients. Flap necrosis, infection, implant failure, nonunion, and osteomyelitis were not observed during the follow-up. Two patients received Lisfranc arthrodesis for persistent pain due to posttraumatic arthritis. In the management of open Lisfranc injury, surgeons must consider soft tissue condition. Staged strategy is a rational protocol for this severe injury. Temporary K-wire fixation after early radical debridement and realignment will facilitate the definitive internal fixation until soft tissue condition improves, which also can decrease the soft tissue complication.
format Online
Article
Text
id pubmed-5413238
institution National Center for Biotechnology Information
language English
publishDate 2017
publisher Wolters Kluwer Health
record_format MEDLINE/PubMed
spelling pubmed-54132382017-05-05 Staged management of open Lisfranc injury: Experience from 14 patients Gu, Wenqi Shi, Zhongmin Medicine (Baltimore) 7100 There are still controversies on the management and outcome of open Lisfranc injury in available studies. This study evaluates the staged management of Lisfranc injury and its complications. Patients who received a staged strategy for open Lisfranc injury were reviewed. One patient with degloving injury suffered from partial skin and hallux necrosis which was treated by debridement, hallux amputation, definitive internal fixation, and local flap transfer on the 12th day after first stage management. A definitive internal fixation and simultaneous skin graft or flap coverage were performed in another 3 patients with soft tissue defects. Other patients without soft tissue problems underwent a second stage of definitive internal fixation. Bone union was observed on the 12.5th week after definitive surgery. The median AOFAS midfoot score at the last follow-up was 74.4 ± 8.7, while the average VAS score was 2.2 ± 1.8. The average return-to-work time was 8th months postoperatively in 9 patients. Flap necrosis, infection, implant failure, nonunion, and osteomyelitis were not observed during the follow-up. Two patients received Lisfranc arthrodesis for persistent pain due to posttraumatic arthritis. In the management of open Lisfranc injury, surgeons must consider soft tissue condition. Staged strategy is a rational protocol for this severe injury. Temporary K-wire fixation after early radical debridement and realignment will facilitate the definitive internal fixation until soft tissue condition improves, which also can decrease the soft tissue complication. Wolters Kluwer Health 2017-04-28 /pmc/articles/PMC5413238/ /pubmed/28445273 http://dx.doi.org/10.1097/MD.0000000000006699 Text en Copyright © 2017 the Author(s). Published by Wolters Kluwer Health, Inc. http://creativecommons.org/licenses/by-nd/4.0 This is an open access article distributed under the Creative Commons Attribution-NoDerivatives License 4.0, which allows for redistribution, commercial and non-commercial, as long as it is passed along unchanged and in whole, with credit to the author. http://creativecommons.org/licenses/by-nd/4.0
spellingShingle 7100
Gu, Wenqi
Shi, Zhongmin
Staged management of open Lisfranc injury: Experience from 14 patients
title Staged management of open Lisfranc injury: Experience from 14 patients
title_full Staged management of open Lisfranc injury: Experience from 14 patients
title_fullStr Staged management of open Lisfranc injury: Experience from 14 patients
title_full_unstemmed Staged management of open Lisfranc injury: Experience from 14 patients
title_short Staged management of open Lisfranc injury: Experience from 14 patients
title_sort staged management of open lisfranc injury: experience from 14 patients
topic 7100
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5413238/
https://www.ncbi.nlm.nih.gov/pubmed/28445273
http://dx.doi.org/10.1097/MD.0000000000006699
work_keys_str_mv AT guwenqi stagedmanagementofopenlisfrancinjuryexperiencefrom14patients
AT shizhongmin stagedmanagementofopenlisfrancinjuryexperiencefrom14patients