Department of Orthopedic Surgery, Seoul Foot and Ankle Center, Inje University Seoul Paik Hospital, 85, 2-ga, Jeo-dong, Jung-gu, Seoul 04551, Republic of Korea.
Department of Orthopedic Surgery, K. B. Bhabha Hospital, Bandra, Mumbai 400050, Maharashtra, India.
Medicina (Kaunas). 2023 Jun 12;59(6):1134. doi: 10.3390/medicina59061134.
Contrary to Lisfranc joint fracture-dislocation, ligamentous Lisfranc injury can lead to additional instability and arthritis and is difficult to diagnose. Appropriate procedure selection is necessary for a better prognosis. Several surgical methods have recently been introduced. Here, we present three distinct surgical techniques for treating ligamentous Lisfranc employing flexible fixation. First is the "Single Tightrope procedure", which involves reduction and fixation between the second metatarsal base and the medial cuneiform via making a bone tunnel and inserting Tightrope. Second is the "Dual Tightrope Technique", which is similar to the "Single Tightrope technique", with additional fixation of an intercuneiform joint using one MiniLok Quick Anchor Plus. Last but not least, the "internal brace approach" uses the SwiveLock anchor, particularly when intercueniform instability is seen. Each approach has its own advantages and disadvantages in terms of surgical complexity and stability. These flexible fixation methods, on the other hand, are more physiologic and have the potential to lessen the difficulties that have been linked to the use of conventional screws in the past.
与跖跗关节骨折脱位相反，韧带性跖跗关节损伤可导致额外的不稳定和关节炎，且难以诊断。为了获得更好的预后，需要选择适当的手术方法。最近已经引入了几种手术方法。在这里，我们介绍了三种使用柔性固定治疗韧带性跖跗关节损伤的不同手术技术。首先是“单绳技术”，通过在第二跖骨基底和内侧楔骨之间制作骨隧道并插入 Tightrope 来实现复位和固定。其次是“双绳技术”，类似于“单绳技术”，通过使用一个 MiniLok Quick Anchor Plus 对中楔骨关节进行额外固定。最后但同样重要的是“内部支撑方法”，使用 SwiveLock 锚钉，特别是当出现中楔骨不稳定时。每种方法在手术复杂性和稳定性方面都有其自身的优缺点。另一方面，这些柔性固定方法更符合生理，并且有可能减轻过去使用传统螺钉所带来的困难。
