Charrois O, Bégué T, Muller G P, Masquelet A C
Service de Chirurgie Orthopédique Traumatologique et Réparatrice, Hôpital Avicenne, Université Paris XIII, Bobigny.
Rev Chir Orthop Reparatrice Appar Mot. 1998 Apr;84(2):197-201.
Plantar fracture-dislocation of the tarso-metatarsal joint (Lisfranc plantar fracture-dislocation) is rather unusual. The authors described a case sustained in a 39 years old man injured in a motorcycle road traffic accident. Mechanism was recognized as plantar hyperflexion combined with an axial foot compression. Open reduction, and K-wires fixation were performed. An anatomical feature was restored. In an additional anatomical study on 8 cadavers, the plantar direction of a fracture-dislocation of the tarso-metatarsal joint was observed when the injury axis followed the scapho-cuneiform joint of the inner border of the foot and the cuboïdo-metatarsal joint on the lateral border, so that both tibialis muscles were fixed on the distal fragment. As tibialis posterior muscle is more powerful, the direction of the dislocation will be plantar. This type of injury is different from plantar fracture-dislocation of the tarso-metatarsal joint secondary to direct load bearing on the dorsum of the foot with severe skin and vessels injuries.
