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European Journal of Trauma and Emergency Surgery

Published in:

01-02-2022 | Original Article

Lisfranc fleck sign: characteristics and clinical outcomes following fixation using a percutaneous position Lisfranc screw

Authors: Moein Pourmorteza, Amir Reza Vosoughi

Published in: European Journal of Trauma and Emergency Surgery | Issue 1/2022

Abstract

Background

Avulsion of the Lisfranc ligament, fleck sign, results in unstable Lisfranc injuries. This cross-sectional study was conducted to investigate the characteristics of Lisfranc injuries with fleck sign and the clinical and radiological outcomes following closed reduction and percutaneous screw fixation.

Methods

All consecutive operatively managed Lisfranc injuries with fleck sign were reviewed from 2016 to 2018. The injury pattern and characteristics of Lisfranc fleck sign were reviewed based on the preoperative CT scan. Postoperative complications besides radiological and clinical outcomes were assessed using visual analog scale (VAS) pain, American orthopedic foot and ankle society (AOFAS) midfoot scale, and foot function index (FFI).

Results

Thirty patients (20 males; mean age, 36.9 ± 17.0; range, 12–69 years) with mean follow-up 16.9 ± 7.4 (range, 6–31) months were enrolled. Among 12 cases with avulsed Lisfranc ligament from the second metatarsal base, only two cases had isolated second metatarsal base fracture in plantar medial part while others had concomitant avulsion fracture of plantar aspect of the adjacent third and/or fourth metatarsal base. Mean of postoperative VAS pain, AOFAS midfoot scale, and FFI were 1.03 ± 0.29, 91.43 ± 1.43, 24.43 ± 6.66, respectively. We had seven (23.3%) removal of screws, two (6.6%) broken screws, four (13.3%) pulled-out screws, and six (20%) lost reductions in the final follow-up with good clinical functions.

Conclusion

Closed reduction and percutaneous fixation of the Lisfranc injuries with fleck sign by a single position screw could be a good surgical option with reliable and predictable outcomes without needing to remove the hardware, routinely.

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Title: Lisfranc fleck sign: characteristics and clinical outcomes following fixation using a percutaneous position Lisfranc screw
Authors: Moein Pourmorteza
Amir Reza Vosoughi
Publication date: 01-02-2022
Publisher: Springer Berlin Heidelberg
Published in: European Journal of Trauma and Emergency Surgery / Issue 1/2022
Print ISSN: 1863-9933
Electronic ISSN: 1863-9941
DOI: https://doi.org/10.1007/s00068-020-01415-z

At a glance: The STEP trials

Springer Medicine

Lisfranc fleck sign: characteristics and clinical outcomes following fixation using a percutaneous position Lisfranc screw

Abstract

Background

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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