Zhang Lei, Jiang Songtao, Wang Ruihan, Cheng Xi, Wu Wangyu, Wang Guoyou
Department of Orthopedics, The Affiliated Traditional Chinese Medicine Hospital, Southwest Medical University, Luzhou, China.
Luzhou Key Laboratory of Orthopedic Disorders, Luzhou, China.
J Orthop Surg Res. 2025 Mar 12;20(1):266. doi: 10.1186/s13018-025-05663-w.
Recently Lisfranc fractures have increased due to increased high-energy injuries from various causes. However, due to incomplete traditional classification, the pattern and distribution of fractures cannot be analyzed in three dimensions. This study examines a novel fracture pattern based on the fracture line and heat map for Lisfranc injuries.
We retrospectively analyzed data from CT scans of 157 patients diagnosed with Lisfranc injuries. We extracted the CT data of a healthy adult and created a standard foot model. We performed 3D reconstruction using patients' CT images and superimposed the fracture model onto the standard model for drawing fracture lines. Subsequently, we converted the fracture lines into a heat map for visualization.
The novel classification identifies high-density fracture sites within the tarsometatarsal joint, predominantly localized in the medial and lateral columns. The fracture lines not involving the TMT joint are mainly located in the medial aspect of the first metatarsal trunk and the fifth metatarsal trunk. Additionally, we develop an assessment protocol for Lisfranc injury that incorporates ligament injury, displacement, and fracture.
The new classification accurately identifies the different types of fractures in Lisfranc injuries, enabling clinicians to more fully and accurately understand their patients' injuries and assisting them in efficiently making sound decisions to avoid diagnostic delays that can negatively impact postoperative outcomes.
近年来，由于各种原因导致的高能损伤增加，Lisfranc骨折的发生率有所上升。然而，由于传统分类不完整，无法从三维角度分析骨折的类型和分布情况。本研究基于骨折线和热图，对Lisfranc损伤的一种新型骨折类型进行了研究。
我们回顾性分析了157例被诊断为Lisfranc损伤患者的CT扫描数据。我们提取了一名健康成年人的CT数据，并创建了一个标准足部模型。我们使用患者的CT图像进行三维重建，并将骨折模型叠加到标准模型上以绘制骨折线。随后，我们将骨折线转换为热图以进行可视化。
这种新型分类法能够识别跗跖关节内的高密度骨折部位，主要集中在内侧柱和外侧柱。未累及跗跖关节的骨折线主要位于第一跖骨干和第五跖骨干的内侧。此外，我们还制定了一种针对Lisfranc损伤的评估方案，该方案纳入了韧带损伤、移位和骨折情况。
这种新的分类法能够准确识别Lisfranc损伤中不同类型的骨折，使临床医生能够更全面、准确地了解患者的损伤情况，并帮助他们有效地做出合理决策，避免可能对术后结果产生负面影响的诊断延误。
