High risk and low incidence diseases: Lisfranc injury.

Autor: McDermott A; Department of Emergency Medicine, MedStar Georgetown University Hospital, Washington, D.C., USA., Repanshek Z; Department of Emergency Medicine, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, USA., Koyfman A; Department of Emergency Medicine, UT Southwestern, Dallas, TX, USA., Long B; Department of Emergency Medicine, Brooke Army Medical Center, Fort Sam Houston, TX, USA. Electronic address: Brit.long@yahoo.com.
Jazyk: angličtina
Zdroj: The American journal of emergency medicine [Am J Emerg Med] 2024 Nov; Vol. 85, pp. 172-178. Date of Electronic Publication: 2024 Sep 11.
DOI: 10.1016/j.ajem.2024.09.019
Abstrakt: Introduction: Lisfranc injuries are uncommon but frequently misdiagnosed and carry a high rate of morbidity.
Objective: This review highlights the pearls and pitfalls of Lisfranc injuries, including presentation, diagnosis, and management in the emergency department (ED) based on current evidence.
Discussion: Lisfranc injuries are caused by high- or low-energy trauma to the tarsometatarsal (TMT) joint complex. The severity of injury exists on a spectrum, ranging from minor subluxations to fractures and dislocations involving the TMT joint complex. They can be complicated by compartment syndrome, neurovascular compromise, and open fractures. Prompt diagnosis is critical in preventing chronic pain and mobility challenges, as even small subluxations can result in significant morbidity. Lisfranc injuries should be considered in all patients with a foot injury. Patients with Lisfranc injuries most commonly present with midfoot pain, swelling, or ecchymosis. Despite the importance of a timely diagnosis, Lisfranc injuries are commonly missed on plain radiographs due to their often subtle findings. When x-rays are negative but there is significant clinical suspicion, emergency clinicians should obtain advanced imaging such as computed tomography to aid in diagnosis. All Lisfranc injuries should be discussed with orthopedic surgery to determine definitive management. Patients who can be discharged should be made non-weightbearing and placed in a short-leg splint.
Conclusion: The consideration of Lisfranc injuries can help emergency clinicians make a timely diagnosis to prevent future complications.
Competing Interests: Declaration of competing interest None. No AI program was utilized in the construction of this manuscript.
(Published by Elsevier Inc.)
Databáze: MEDLINE
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