NDLI: Ipsilateral floating second metatarsal and ankle fracture dislocation: complications and outcome of a rare type of injury.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Lasanianos, N. G. Kanakaris, N. K. Harris, N. Giannoudis, P. V.
Description	Country affiliation: United kingdom Author Affiliation: Lasanianos NG ( Academic Unit of Trauma and Orthopedics, University of Leeds, Leeds General Infirmary, Leeds, United Kingdom.)
Abstract	Lisfranc fracture dislocations are complex lesions which, when combined with additional trauma of the ankle and foot region, create a difficult to treat injury pattern. This article presents a case of a patient with Lisfranc fracture dislocation combined with metatarsophalangeal dislocation of the second toe and ankle fracture-dislocation. The sequence of medical acts and complications included: reduction of dislocations, cast immobilization, compartment syndrome and fasciotomies, external fixator application, fasciotomies closure, and final internal fixations. The following examinations were performed: radiography, computed tomography (CT), and intracompartmental pressure measurement. Despite the compartment syndrome incidence, which was effectively managed, the patient regained an ankle- and foot-pain-free full range of motion. Although this is an isolated case of a rare injury, several recommendations can be made. Early CT scan should be used for injuries of the Lisfranc joints to fully assess the distorted anatomy of the midfoot and forefoot, which is essential for preoperative planning, medicolegal issues, and prognosis of the injury. The use of a spanning external fixator, especially in complex injuries as the one described, should be preferred to cast immobilization and should be performed as a priority surgical procedure early on in the patient's admission. The development of compartment syndrome should be monitored and intracompartmental pressures measured especially in unconscious patients. There should be a high degree of suspicion for early complications in complex fracture patterns, even if the initial clinical assessment is reassuring.
File Format	HTM / HTML
ISSN	01477447
Volume Number	33
Journal	Orthopedics
e-ISSN	19382367
Issue Number	5
DOI	10.3928/01477447-20100329-28
Language	English
Publisher	SLACK Incorporated
Publisher Place	United States
Access Restriction	Subscribed
Subject Keyword	Discipline Orthopedics Ankle Injuries Complications Foot Injuries Fractures, Bone Dislocations Adult Surgery Humans Male Radiography Case Reports Journal Article
Content Type	Text
Resource Type	Case study Article
Subject	Orthopedics and Sports Medicine Surgery

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