Hoskins Meloria, Wise Patrick, Unangst Alicia, Shaheen Philip, Kreulen Christopher, Aynardi Michael, Giza Eric
Department of Orthopaedic Surgery, Penn State Milton S. Hershey Medical Center, Penn State Hershey Bone and Joint Institute, 30 Hope Dr Suite 2400, Hershey, PA 17033 USA.
Department of Orthopaedic Surgery, University of California Davis Medical Center, Academic Offices 4860 Y Street, Suite 3800, Sacramento, CA USA.
Indian J Orthop. 2024 Feb 2;58(3):257-262. doi: 10.1007/s43465-024-01097-4. eCollection 2024 Mar.
The treatment of Lisfranc injuries continues to evolve with time. The purpose of this study was to report early outcomes of patients with Lisfranc ligamentous injuries treated with the Arthrex InternalBrace, which has benefits to other previously described techniques.
We retrospectively identified 15 adult patients with Lisfranc injuries that were treated via open reduction internal fixation with the Arthrex InternalBrace (Naples, Fl). These patients were identified at two separate United States institutions between 2019 and 2022. Demographic data, mechanism of injury, and concomitant foot injuries were recorded. Outcomes were assessed by return-to-work or sport and time to weight-bearing. Secondary complications or revision surgeries were noted.
The mean patient age was 35 years. Eight patients had isolated Lisfranc ligamentous injuries and seven had additional intercuneiform instability, which required a supplemental limb of the fixation device. The most common mechanism of injury was a cutting/pivoting maneuver ( = 5) followed by fall ( = 4). The mean radiographic follow-up time was 7.3 months. The average time to weight-bearing as tolerated was 6.6 weeks (± 2.2). The average time to return-to-work/sport as tolerated was 14.1 weeks (± 3.6). Only two minor complications were noted at follow-up but no major complications or revision surgeries occurred.
The outcomes of this case series suggest that the Arthrex InternalBrace is a viable option when performing open reduction and internal fixation of Lisfranc ligamentous injuries. Future prospective studies are needed to directly compare this device with alternative fixation methods.
随着时间的推移，Lisfranc损伤的治疗方法不断发展。本研究的目的是报告采用Arthrex内固定支具治疗Lisfranc韧带损伤患者的早期疗效，该支具比先前描述的其他技术具有优势。
我们回顾性地确定了15例接受Arthrex内固定支具（佛罗里达州那不勒斯）切开复位内固定治疗的成人Lisfranc损伤患者。这些患者于2019年至2022年期间在美国的两家不同机构被确定。记录了人口统计学数据、损伤机制和足部合并损伤。通过重返工作或运动情况以及负重时间来评估疗效。记录了次要并发症或翻修手术情况。
患者的平均年龄为35岁。8例患者为孤立的Lisfranc韧带损伤，7例伴有楔骨间不稳定，需要固定装置的补充肢体。最常见的损伤机制是切割/旋转动作（n = 5），其次是跌倒（n = 4）。平均影像学随访时间为7.3个月。耐受负重的平均时间为6.6周（±2.2）。耐受重返工作/运动的平均时间为14.1周（±3.6）。随访时仅发现2例轻微并发症，但未发生重大并发症或翻修手术。
本病例系列的结果表明，在对Lisfranc韧带损伤进行切开复位内固定时，Arthrex内固定支具是一种可行的选择。未来需要进行前瞻性研究，将该装置与其他固定方法进行直接比较。
