The Department of Orthopaedics and Rehabilitation, University of New Mexico, Albuquerque, NM, USA.
University of New Mexico School of Medicine, Albuquerque, NM, USA.
Foot Ankle Int. 2024 Aug;45(8):896-904. doi: 10.1177/10711007241250024. Epub 2024 May 26.
Lisfranc injuries are often treated with open reduction and internal fixation using rigid fixation techniques. The use of flexible fixation to stabilize the Lisfranc joint is a newer technique. The purpose of this cadaveric study is to compare the amount of diastasis at the Lisfranc interval under diminished physiologic loads when treated with a knotless suture tape construct and a solid screw.
Ten cadavers (20 feet) had native motion at the intact Lisfranc interval assessed at multiple increasing loads (69, 138, and 207 N). The Lisfranc ligamentous complex was then disrupted, and testing repeated to evaluate the amount of diastasis. Randomization was performed to determine the type of fixation for each cadaver: solid screw or knotless suture tape construct. Once fixation was completed, specimens were cyclically loaded for 10 000 cycles at loads, and diastasis was quantified after each load cycle to compare the interventions. Diastasis was measured using motion tracking cameras and retroreflective marker sets. A non-inferiority statistical analysis was performed.
Diastasis mean values were confirmed to be >2 mm for all load bearing conditions in the injury model. Posttreatment, diastasis was significantly reduced when compared to the sectioned conditions ( < .01) for both treatment options. Non-inferiority analyses showed that the knotless suture tape construct did not perform inferior to screw fixation for diastasis at the Lisfranc interval at any of the compared load states.
Under the loads tested, there is no significant difference in diastasis at the Lisfranc interval when treating ligamentous Lisfranc injuries with a knotless suture tape construct or solid screws. Both reduced diastasis from the injured state and were not different from the intact state.
In this cadaveric model with ligamentous Lisfranc injury, diastasis of a knotless suture tape construct is compared to solid screw fixation as tested.
Lisfranc 损伤通常采用切开复位内固定术，采用刚性固定技术。使用柔性固定来稳定 Lisfranc 关节是一种较新的技术。本尸体研究的目的是比较在生理负荷降低的情况下，使用无结缝线带和实心螺钉固定时，Lisfranc 间隙的分离程度。
10 具尸体（20 只脚）在完整的 Lisfranc 间隙处进行了多次增加负荷（69、138 和 207 N）的固有运动评估。然后破坏 Lisfranc 韧带复合体，重复测试以评估分离程度。对每个尸体进行随机分组，确定固定方式：实心螺钉或无结缝线带。完成固定后，在负荷下进行 10000 次循环加载，在每个负荷循环后量化分离程度，以比较干预措施。使用运动跟踪摄像机和反射标记套件测量分离程度。进行非劣效性统计分析。
在损伤模型的所有承重条件下，分离度的平均值均>2 mm。与切开条件相比，两种治疗方案的治疗后分离度均显著降低（<0.01）。非劣效性分析表明，在任何比较的负荷状态下，无结缝线带在 Lisfranc 间隙的分离度上均不劣于螺钉固定。
在测试的负荷下，使用无结缝线带或实心螺钉治疗 Ligamentous Lisfranc 损伤时，Lisfranc 间隙的分离度没有显著差异。两种方法都能减少损伤状态下的分离度，且与完整状态下无差异。
在本韧带 Lisfranc 损伤的尸体模型中，比较了无结缝线带和实心螺钉固定的分离度。
