A Prospective Study on the Operative Outcomes of Lisfranc’s Fracture Dislocation.

Abstract

Introduction- When one or more of the metatarsals are dislocated with regard to the tarsus, this is known as a Lisfranc injury. This phrase has a wide range of use; it may describe a mild sprain or a severe laceration, a solely ligamentous injury or one coupled with a fracture of the metatarsals, cuneiform bones, or cuboid. are unusual, making them easy to miss during a patient's first evaluation and therapy. Lisfranc injuries account for just around 0.2% of all fractures, but are either misdiagnosed or treated too late in 20% of cases. Males are two to four times more likely to get a Lisfranc joint injury than women, probably because to their greater propensity to engage in high-velocity activities. Injuries like this are frequent in people's thirties. The vast majority of these injuries (87.5%) are closed fractures, and they are on the rise among sportsmen, who often suffer from mild Lisfranc injuries. Nevertheless, adequate treatment and prevention of long-term effects depend on early and correct detection of these injuries. Method- Thirty instances of Lisfranc's fracture dislocation were examined; “surgery was performed on the medial (1st tarsometatarsal joint), middle (the second and third tarsometatarsal joints), and lateral (the fourth and fifth tarsometatarsal joints) columns, using screws and Kirschner wires, respectively.” Lisfranc screws, metacarpal base to second metatarsal 4 or 4.5 mm non-cannulated screw from the first cuneiform to the second metatarsal base Screws or a K-wire of either 3.5 mm in diameter and not cannulated, crossed, or used alone Dorsal facets K-wires, Cannulated Cancellous Screws, and Cannulated Plate and Screws (Kirschner Wires). The American Orthopaedic Foot and Ankle Society (AOFAS) was used to assess functional recovery. Result-In our study, 30 patients were treated with the average age being 32.4 years, 11 cases (36.77%) were open type fractures and 19 cases (63.33%) were closed type fractures.  We were able to achieve Excellent Outcome in 13.33% of the cases. In our research, the overall “AOFAS (American Orthopaedic Foot and Ankle Score) was 76.5, with Good Result in 70% of cases, Fair Outcome in 13.3% of cases, and no patients having Poor Outcome.” Conclusion- Lisfranc fracture-dislocations caused by high-impact forces are simple to identify. Low-energy Lisfranc ligament injuries are often overlooked. Lisfranc injury has a significant morbidity rate if treatment is delayed or neglected. Suspicion is strong even for a midfoot A sprain may be used as a diagnostic tool. Achieving appropriate anatomical reduction is the single most essential aspect in producing desirable functional and radiographic outcomes. Current study indicates that Cannulated Cancellous Screws, plates with screws, and K Wires are an effective technique of therapy that delivers a favorable functional outcome without substantially raising the risk for post-operative problems, and are well-liked by patients.