Tightrope system in the treatment of purely ligamentous Lisfranc injuries can stabilize the tarsometatarsal joint and achieve satisfactory effect. No complications occurred during the operation. The Tightrope system was not removed and the foot obtained better biomechanical stability. There was statistically significant difference in the distance between the first and second metatarsal joint and VAS score at 3 months, 6 months, and the last follow-up when compared with preoperative values ( P < 0.05).Mean of postoperative AOFAS mid-foot scale and Maryland foot score were 92.4 ± 4.3, 94.1 ± 3.5, respectively. The average follow-up time was 20.5 months (range, 17–24). American orthopedic foot & ankle society (AOFAS) and Maryland foot score were recorded at the last follow-up. X-ray was performed regularly after operation to measure the distance between the first and second metatarsal joint and the visual analogue scale (VAS) score was used to evaluate pain relief. We retrospectively analyzed 11 cases with purely ligamentous Lisfranc injuries treated with the Tightrope system from 2016 to 2019, including 8 male and 3 female. This study evaluated the effect of using the Tightrope system to reconstruct the Lisfranc ligament for elastic fixation. There are several operative techniques for rigid fixation to solve this problem clinically. doi:10.1016/j.fcl.2017.09.Purely ligamentous Lisfranc injuries are mainly caused by low energy damage and often require surgical treatment. Diagnostic Imaging of the Foot and Ankle. Ulrike Szeimies, Axel Stbler, Markus Walther. Infraction of the Second Metatarsal - A Typical Injury. Freiberg's disease: a suggested pattern of management. Freiberg's infraction of the second metatarsal head with formation of multiple loose bodies. MRI of metatarsal head subchondral fractures in patients with forefoot pain. Torriani M, Thomas BJ, Bredella MA et-al. Freiberg disease complicating unrelated trauma. Lesser metatarsal head instability (only identified on MRI): due to plantar plate tear Including subchondral insufficiency fracture Normal variant: metatarsal head flattening is described in ~10% of the asymptomatic population History and etymologyĪlbert H Freiberg (1868-1940) was an American orthopedic surgeon who first described his eponymous condition in 1914 8,9,11. It is usually divided into joint preserving or reconstruction options 12. In advanced stages, surgery can be considered. In early stages of the disease, it can be managed with lifestyle modifications, immobilization and NSAID therapy. With disease progression, flattening of the metatarsal head occurs, and low-signal-intensity changes develop on T2-weighted images as the bone becomes sclerotic. Widening of the metatarsophalangeal jointĮarly MRI findings include low-signal-intensity changes in the metatarsal head on T1-weighted images with increased signal intensity on corresponding T2-weighted and STIR images. These can be split into early and late features: Earlyįlattening and cystic lesions of the affected metatarsal head Stage III: metatarsophalangeal osteoarthrosis with intra-articular loose bodies Stage II: metatarsal head sclerosis, fragmentation, and deformation, with cortical thickening Stage I: metatarsal head flattening and decreased subchondral bone density Some publications advocate the use of the Bragard staging classification 10, which requires two views/planes of the forefoot: Histologically, Freiberg disease is characterized by the collapse of the subchondral bone, osteonecrosis, and cartilaginous fissures 1. The cause of Freiberg disease is controversial and is probably multifactorial.Ī traumatic insult in the form of either acute or repetitive injury and vascular compromise, perhaps due to an elongated 2 nd metatarsal, are the most popular theories, and as it is more commonly seen in women, particularly during adolescence, high-heeled shoes have been postulated as a possible causative factor. Clinical presentationĬlinically they present with pain on weight-bearing with swelling and tenderness. It is most common in females aged 10-18 years (M:F = 1:3).
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |