Neoligamentplasty for the Treatment of Subtle Ligament Lesions of the Intercuneiform and Tarsometatarsal Joints

Autor: Nery, Caio, Réssio, Cibele, Alloza, José Felipe Marion
Zdroj: Techniques in Foot & Ankle Surgery; September 2010, Vol. 9 Issue: 3 p92-99, 8p
Abstrakt: Between 1995 and 2007, 20 patients with subtle Lisfranc joint injuries were treated. All patients confirmed that they had suffered a foot sprain with the forefoot fixed to the surface. In 12 patients (60), the accessory force acted in eversion and in 8 patients (40), in inversion. Only 11 patients (55) showed radiographic signs that could confirm the suspicion of the clinical diagnosis. Magnetic resonance images confirmed the involvement of anatomic structures in all of them. The ruptured ligaments were explored and their residue removed—one of the aims of the surgery that will control the pain and lead to the reduction of the joints. After the reduction, drill holes were made to reproduce the isometrics and anatomy of the torn ligaments. After an average follow-up of 8 years (2-13 y), 17 patients (85) were considered as having excellent or good results (complete recovery of motion and power; no pain; no soft tissue or bone reaction to the neoligaments; no loss of anatomic reduction); and 3 patients (15) had fair or poor results (arthritis). Resection of torn ligaments, anatomic reduction of the subluxated joints, and isometric reconstruction of the ligaments showed to be an excellent solution to the subtle Lisfranc injuries and an alternative to other methods of treatment.
Databáze: Supplemental Index