To fuse or not to fuse the Lis Franc Joint? The rationale

Abstract

Introduction: The term “Lisfranc injury” commonly describes injuries which occur at the bases of the five metatarsals, their articulations with the distal four tarsal bones, and the Lisfranc ligament. The injury is rare and accounts for 0.2% of all fractures with up to 20% of injuries being missed in the acute setting. The treatment of these injuries has been the subject of much debate over the years. Primary arthrodesis has increased as a treatment option for acute injuries in the recent literature. Case Report: A 25-year-old female with Type 1 diabetes mellitus presented with a two-week history of a swollen right foot after falling while descending a flight of stairs. Radiographic imaging revealed a partial incongruity of her right Lis franc joint with a comminuted fracture of the second tarsometatarsal joint. She underwent a primary arthrodesis of the Lis Franc joint with no functional impairment or midfoot deformity progression at one year follow up.Conclusion: This construct has shown to better withstand the abnormal biomechanical forces which are placed on the midfoot during ambulation in patients with peripheral neuropathy such as diabetics. The case presented highlights the benefits of this treatment modality in the young, diabetic patient.