Classification and Outcome of Fracture-Dislocation of the Cuneiform Bones
| Autor: | Maria Anna Lena Legrand, Hagen Schmal, Alexander T. Mehlhorn, Peter C. Strohm, Norbert P. Südkamp |
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| Rok vydání: | 2016 |
| Předmět: |
Adult
Male medicine.medical_specialty medicine.medical_treatment Cohort Studies Fracture Fixation Internal Young Adult 03 medical and health sciences 0302 clinical medicine medicine Humans Injury mechanisms Orthopedics and Sports Medicine Reduction (orthopedic surgery) Cuneiform 030222 orthopedics Cuneiform bones Fracture Dislocation business.industry Reproducibility of Results Tarsal Bones 030229 sport sciences Conventional radiographs Middle Aged Direct trauma Surgery Treatment Outcome medicine.anatomical_structure Cuneonavicular joint Fracture (geology) Female business |
| Zdroj: | The Journal of Foot and Ankle Surgery. 55:1249-1255 |
| ISSN: | 1067-2516 |
| DOI: | 10.1053/j.jfas.2016.01.019 |
| Popis: | Fractures and dislocations of the cuneiform bones are rare injuries to the midtarsal foot. The injury severity is often unclear, and the prognostic factors are unknown. The purpose of the present study was to characterize our insights of the diagnostics, therapy, and fracture patterns. We questioned whether the number of involved cuneiform bones and the type of injury would affect the clinical outcome. With this information, we aimed to develop a classification system for injuries of the cuneonavicular joint. Five patients who had sustained complex fracture-dislocation of the cuneiform bones were prospectively registered, underwent surgery, and were followed. We reviewed the published data and found 47 reports that included 55 patients to improve the informative value of our study. The injury mechanisms and therapy were evaluated, and the postoperative limitations and pain were assessed. The clinical outcome was correlated with the number of involved cuneiforms and the fracture/dislocation pattern. Direct trauma was associated with isolated fracture, and indirect injury was associated with isolated dislocations. Occasionally, these injuries were overlooked on conventional radiographs, and closed reduction frequently failed. The number of cuneiform bones involved and the type of injury were shown to affect the clinical outcome. We devised an easily applicable classification system for injuries to the cuneiform bones using this information. All cases were classified as isolated fractures (1), isolated dislocations (2), or fracture-dislocations (3) involving 1 (A), 2 (B), or 3 (C) cuneiform bones. The classification system we propose will facilitate a better understanding of the fracture patterns at the cuneonavicular joint line and is a good prognostic tool that requires validation in clinical settings. |
| Databáze: | OpenAIRE |
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