Our Summary

This research paper discusses Lisfranc injuries, which often go unnoticed and can occur on their own or alongside other injuries. To identify or better understand these injuries, weight-bearing x-rays or more advanced scans like CT scans may be necessary. Surgery, specifically fusion, is often required for Lisfranc injuries that involve ligament damage, have been left untreated for a while, or have caused arthritis. Fusion might also be considered right after a fracture rather than using other techniques that involve opening up the foot and securing the bones with hardware. The main aim of surgery is to stabilize the middle part of the foot and restore its natural arch. The paper includes a video demonstrating a method for fusing the joints in the foot, which could be beneficial for treating both ligament and bone-related Lisfranc injuries.

FAQs

  1. What are the common indications for fusion after a Lisfranc injury?
  2. What are the primary goals of surgery following a Lisfranc injury?
  3. Can the tarsometatarsal joint fusion technique be used for both ligamentous and bony varieties of Lisfranc injury?

Doctor’s Tip

A helpful tip a doctor might tell a patient about joint fusion is to follow post-operative rehabilitation guidelines closely to ensure proper healing and optimal outcomes. This may include physical therapy, activity modification, and follow-up appointments with the doctor to monitor progress. It is important to communicate any concerns or changes in symptoms to the doctor promptly.

Suitable For

Patients who are typically recommended joint fusion for lisfranc injuries include those with primarily ligamentous injuries, delayed or chronic presentations, post-traumatic arthritis, or acute fractures that may not be suitable for open reduction internal fixation techniques. The goal of the surgery is to provide stability to the midfoot and restore the anatomical arch/cascade.

Timeline

Before joint fusion:

  • Patient experiences a lisfranc injury, which may be missed or misdiagnosed initially
  • Patient may undergo imaging such as weight-bearing films or CT scans to identify the extent of the injury
  • Common indications for fusion include ligamentous injuries, delayed/chronic presentations, or post-traumatic arthritis

After joint fusion:

  • Patient undergoes surgery to fuse the tarsometatarsal joint in the setting of acute lisfranc injury
  • Surgery aims to provide stability to the midfoot and restore the anatomical arch/cascade
  • Fusion may be used for both ligamentous and bony varieties of lisfranc injury.

What to Ask Your Doctor

  1. Can you explain the reasons for recommending joint fusion in my case?
  2. What are the potential risks and complications associated with joint fusion surgery?
  3. What is the expected recovery time and rehabilitation process after joint fusion surgery?
  4. Will I be able to maintain the same level of activity and mobility after joint fusion surgery?
  5. Are there any alternative treatments or procedures that could be considered instead of joint fusion?
  6. How successful is joint fusion surgery in relieving pain and improving function in patients with lisfranc injuries?
  7. What type of anesthesia will be used during the surgery and what can I expect during the procedure?
  8. How long will the fusion take to fully heal and what are the long-term outcomes of joint fusion surgery?
  9. Are there any lifestyle changes or modifications I should consider after joint fusion surgery?
  10. What is the follow-up care plan after joint fusion surgery and when will I be able to return to normal activities?

Reference

Authors: Jonard B, Wroblewski A, Junko J. Journal: J Orthop Trauma. 2019 Aug;33 Suppl 1:S42-S43. doi: 10.1097/BOT.0000000000001542. PMID: 31290835