Lisfranc injury
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Lisfranc injuries involve dislocations of the tarsometatarsal joints of the midfoot. They are named after Jacques Lisfranc de St. Martin, a French surgeon from the 1800s. Clinically, patients experience midfoot pain made worse with weight bearing and stress tests of the midfoot. Imaging like x-rays can reveal misalignments of bones in the midfoot. Treatment may involve casting without weight bearing for non-surgical cases or surgery to realign bones with internal fixation for more severe injuries.
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This document discusses longitudinal deficiency of the femoral partial (LDFP), which is a congenital absence of part or all of the femur associated with other lower limb abnormalities. It can be unilateral or bilateral. The etiology is unknown but may involve vascular or infection issues. Clinical presentation includes a shortened lower limb, thickened thigh, foot deformities, and abnormal limb positioning. Treatment options include surgical procedures like ankle disarticulation or femoral-pelvic fusion, or non-surgical approaches like prosthetics tailored to the specific classification and severity of the LDFP. Prosthetic fittings aim to address limb length discrepancy, joint instability, muscle inadequacy, and functional needs.
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Lisfranc injuries involve dislocations or fractures at the tarsometatarsal joint complex of the midfoot. This joint complex connects the tarsal bones of the midfoot to the bases of the metatarsal bones and is an important stabilizer of the longitudinal arch. Lisfranc injuries are often caused by high-energy trauma like motor vehicle accidents. Clinical features include pain and swelling in the midfoot region making it difficult to bear weight. X-rays can reveal bone displacements at the joint. Treatment involves surgical repair through open reduction and internal fixation using screws to restore normal bone alignment, followed by non-weightbearing casting.
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stabilizer of patella during initial 30 degree of flexion.
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Runs in layer 2 on medial aspect of the knee.
Origin- 1.9mm anterior/3.8 mm distal to adductor tubercle.(Laparade JBJS- Am.07)
Insertion – proximal 2/3 of patella
Along Distal edge of VMO
Broad insertion over 28.2+_ 5.6 mm over proximal 2/3 patella.
Average length 59.8mm +_ 4.8mm.
Passive- Trochlear constraints
Depth ,length(Height)
Patellar engagement
Capsular ligamentous tethers, especially MPFL
(Hautamaa, Fithian et al. 1998)
Dynamic elements
Simulated muscle tension has little effect on patellar mobility. Regardless of flexion angle
(Scnavongers, Farahmand et al 2003
Lisfranc injury
A Lisfranc injury involves trauma to the tarsometatarsal joint complex of the midfoot. Left untreated or misdiagnosed, it can significantly impair a patient's mobility and quality of life. The document discusses the anatomy of the Lisfranc joint and ligaments, mechanisms of injury, classification systems, clinical and radiographic evaluation methods, and management approaches. Treatment may involve closed reduction, surgical fixation, or arthrodesis depending on the injury severity and degree of displacement. The goal is to restore anatomical alignment and joint stability for optimal long-term outcomes.
Triple arthrodesis
Triple arthrodesis is a surgical fusion of the subtalar, calcaneocuboid, and talonavicular joints to provide hindfoot stability and alignment and relieve pain. It is used to treat conditions like rheumatoid arthritis, post-traumatic arthritis, osteoarthritis, Charcot-Marie-Tooth disease, neglected clubfoot, poliomyelitis, and tarsal coalition. The Lambrinudi procedure is used for severe clubfoot and involves wedge resections of the calcaneum, talus, and navicular followed by fixation with K-wires, staples or screws. Postoperatively, the limb is immobilized for 6 weeks followed by ankle-foot orthosis use and weight bearing
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Lisfranc injury
A Lisfranc injury involves fracture or ligament disruption of the tarsometatarsal joint complex of the midfoot. It results from high-energy twisting or axial loading injuries and often requires surgical fixation to achieve proper anatomical reduction. Non-operative treatment may be considered for non-displaced or minimally displaced injuries. Proper diagnosis involves weight-bearing radiographs to assess joint congruity, and sometimes CT or MRI. Surgical management focuses on anatomical reduction and stable fixation of the joints to allow early weight bearing and prevent post-traumatic arthritis.
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This document discusses instability after total knee arthroplasty (TKA). It begins by outlining the goals and basic principles of TKA. It then describes the bone cuts made during TKA and emphasizes that resection of the proximal tibia influences both flexion and extension gaps. The document discusses various causes of instability after TKA including improper bone cuts, soft tissue imbalance, and component malpositioning. It provides details on managing different types of instability such as instability in extension, flexion, and mid-flexion. Prevention of instability through proper bone cuts and soft tissue balancing is emphasized.
Calcaneal fractures
Here are the key steps in the ORIF procedure:
1. Patient is placed in lateral decubitus position and a right-angled lateral incision is made to minimize soft tissue damage.
2. The fracture line at the angle of Gissane is identified.
3. Fragments are temporarily held in place with K-wires under fluoroscopy while the reconstruction restores the 3D shape of the calcaneus.
4. The "constant" sustentacular fragment is used to begin the reconstruction, working anteriorly and medially.
5. Traction may be needed to restore the posterior facet.
6. The lateral wall fragment is closed like a door last to complete the
Ankle arthrodesis
This document provides information on ankle arthrodesis. It begins by describing the anatomy of the ankle joint and its biomechanics. It then discusses indications for ankle arthrodesis including various types of arthritis. Conservative management is outlined followed by details of the surgical procedure including patient evaluation, approaches, fixation methods, post-operative care and alternatives to fusion. Specific techniques like transfibular arthrodesis with a fibular strut graft are explained. The goal of ankle arthrodesis is to fuse the ankle joint to relieve pain from arthritis while maintaining alignment and function.
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39. tibial plafond (pilon) fractures
This document discusses tibial pilon fractures, which involve fractures of the distal tibial articular surface. Key points include:
1) The term "tibial pilon" was first used in 1911 to describe the distal tibia resembling a pestle. Pilon fractures account for 7-10% of tibial fractures and usually result from high-energy mechanisms.
2) Classification systems include the Rüedi-Allgöwer system (based on articular displacement/comminution) and the AO/OTA system (which further subdivides based on extra-articular involvement and comminution).
3) Treatment involves restoring tibial alignment, stabilizing the fracture to facilitate union,
Ottopelvis
Otto Pelvis, also known as primary protrusio acetabuli, was first described by German pathologist Otto in 1824. It is characterized by medial protrusion of the acetabulum. There are two types: primary, which remains a diagnosis of exclusion, and secondary. Clinical features include a marked female predilection and bilateral involvement. Radiographs can identify protrusio using Kohler's line or central edge angle. Management depends on age and degeneration, ranging from valgus osteotomy in younger patients to total hip arthroplasty with grafting in older patients. Surgical techniques aim to restore the hip center through lateralization and reconstruction of bone defects.
Intertrochanteric & subtrochanteric fracture classification
This document discusses different classification systems used for intertrochanteric and subtrochanteric hip fractures. It describes the Evans classification system which categorizes fractures as stable or unstable based on the integrity of the posteromedial cortex. The Orthopaedic Trauma Association classification system uses alphanumeric codes to further describe fracture patterns. For subtrochanteric fractures, the document outlines the Fielding, Seinsheimer, Russell-Taylor, and AO classification systems which take into account factors like the position of fracture lines, stability, and degree of comminution.
Distal Radioulnar Joint (DRUJ) Injuries
This document discusses injuries to the distal radioulnar joint (DRUJ). It begins with an overview of the anatomy of the DRUJ and its importance. It then describes various types of DRUJ injuries including acute dislocations or injuries associated with fractures. Chronic injuries and arthritis are also discussed. Evaluation methods like imaging and clinical exams are provided. The classification and treatment options for different DRUJ injuries are explained, including non-operative and surgical treatments like repair, reconstruction or resection procedures.
Lisfranc
1) A Lisfranc fracture is a fracture or dislocation of the tarsal bones where they meet the bases of the metatarsal bones in the midfoot.
2) It is usually caused by high-energy twisting injuries or axial loading with the foot fixed. Common mechanisms are falls from heights or motor vehicle accidents.
3) Diagnosis involves x-rays of the foot, and sometimes CT or MRI to further evaluate bone and ligament injuries. Operative treatment is usually needed for displaced fractures to restore the normal alignment of the bones.
Lisfranc injury-
The document discusses Lisfranc injuries, which involve fractures or ligament tears around the tarsometatarsal joint complex of the midfoot. It provides details on the anatomy of the Lisfranc joint and ligaments, classification systems for injuries, mechanisms of injury, clinical and radiographic evaluation methods, and treatment approaches including casting, surgery, and postoperative care. Surgical treatment aims to restore anatomical alignment through open reduction and internal fixation, while nonsurgical treatment is considered for minor injuries with little displacement. Complications can include arthritis, deformity, and hardware issues if not properly treated.
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This document provides information on Lisfranc injuries, which involve fractures or dislocations of the tarsometatarsal joint complex of the midfoot. It describes the anatomy of the Lisfranc joint, classification of injuries, evaluation, treatment options, postoperative care, outcomes, and complications. Lisfranc injuries can range from mild sprains to severely displaced fractures and dislocations and are often difficult to diagnose due to swelling obscuring physical exam findings. Treatment may involve closed reduction and casting for non-displaced or mildly displaced injuries, while more severe injuries typically require open reduction and internal fixation with screws.
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This document discusses recurrent dislocation of the patella. It begins with relevant anatomy of the patella and its stabilizers. Predisposing factors for dislocation include increased Q angle, trochlear dysplasia, and patella alta. Clinical features include pain, a feeling of instability, and positive apprehension and grind tests. Radiographs can evaluate patellar height and alignment. Management includes initial immobilization and rehabilitation, with surgery considered for recurrent or unstable cases. Surgical options are categorized based on risk/reward, and include soft tissue procedures like medial repair/MPFL reconstruction or distal realignment procedures like the Elmslie-Trillat operation. The key is identifying the underlying pathology and tailoring
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Lisfranc injuries involve dislocations or fractures at the tarsometatarsal joint complex of the midfoot. This joint complex connects the tarsal bones of the midfoot to the bases of the metatarsal bones and is an important stabilizer of the longitudinal arch. Lisfranc injuries are often caused by high-energy trauma like motor vehicle accidents. Clinical features include pain and swelling in the midfoot region making it difficult to bear weight. X-rays can reveal bone displacements at the joint. Treatment involves surgical repair through open reduction and internal fixation using screws to restore normal bone alignment, followed by non-weightbearing casting.
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This document provides an overview of the anatomy of the ankle joint and ankle arthrodesis (fusion). It describes the bones and ligaments that make up the ankle joint, including the tibia, fibula, and talus. It discusses the indications, contraindications, surgical technique, and postoperative care of ankle arthrodesis, which is performed to treat ankle arthritis and pain. The optimal position for fusion is slight dorsiflexion with mild hindfoot valgus and external rotation. Preoperative planning involves assessing bone quality, alignment, and arthritis in other joints like the subtalar.
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Runs in layer 2 on medial aspect of the knee.
Origin- 1.9mm anterior/3.8 mm distal to adductor tubercle.(Laparade JBJS- Am.07)
Insertion – proximal 2/3 of patella
Along Distal edge of VMO
Broad insertion over 28.2+_ 5.6 mm over proximal 2/3 patella.
Average length 59.8mm +_ 4.8mm.
Passive- Trochlear constraints
Depth ,length(Height)
Patellar engagement
Capsular ligamentous tethers, especially MPFL
(Hautamaa, Fithian et al. 1998)
Dynamic elements
Simulated muscle tension has little effect on patellar mobility. Regardless of flexion angle
(Scnavongers, Farahmand et al 2003
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A Lisfranc injury involves trauma to the tarsometatarsal joint complex of the midfoot. Left untreated or misdiagnosed, it can significantly impair a patient's mobility and quality of life. The document discusses the anatomy of the Lisfranc joint and ligaments, mechanisms of injury, classification systems, clinical and radiographic evaluation methods, and management approaches. Treatment may involve closed reduction, surgical fixation, or arthrodesis depending on the injury severity and degree of displacement. The goal is to restore anatomical alignment and joint stability for optimal long-term outcomes.
Triple arthrodesis
Triple arthrodesis is a surgical fusion of the subtalar, calcaneocuboid, and talonavicular joints to provide hindfoot stability and alignment and relieve pain. It is used to treat conditions like rheumatoid arthritis, post-traumatic arthritis, osteoarthritis, Charcot-Marie-Tooth disease, neglected clubfoot, poliomyelitis, and tarsal coalition. The Lambrinudi procedure is used for severe clubfoot and involves wedge resections of the calcaneum, talus, and navicular followed by fixation with K-wires, staples or screws. Postoperatively, the limb is immobilized for 6 weeks followed by ankle-foot orthosis use and weight bearing
Hallux valgus
Hallux valgus, or a deviated great toe, is a common foot deformity. It involves the lateral deviation of the great toe with valgus of the first metatarsal. It can cause pain and make shoe wearing difficult. While small deformities may be treated with proper shoes, surgery is often needed for more severe cases to realign bones and tissues. The document discusses the anatomy, causes, classifications, symptoms, investigations and various surgical procedures used to treat hallux valgus.
Lisfranc injury
A Lisfranc injury involves fracture or ligament disruption of the tarsometatarsal joint complex of the midfoot. It results from high-energy twisting or axial loading injuries and often requires surgical fixation to achieve proper anatomical reduction. Non-operative treatment may be considered for non-displaced or minimally displaced injuries. Proper diagnosis involves weight-bearing radiographs to assess joint congruity, and sometimes CT or MRI. Surgical management focuses on anatomical reduction and stable fixation of the joints to allow early weight bearing and prevent post-traumatic arthritis.
Instability in TKR
This document discusses instability after total knee arthroplasty (TKA). It begins by outlining the goals and basic principles of TKA. It then describes the bone cuts made during TKA and emphasizes that resection of the proximal tibia influences both flexion and extension gaps. The document discusses various causes of instability after TKA including improper bone cuts, soft tissue imbalance, and component malpositioning. It provides details on managing different types of instability such as instability in extension, flexion, and mid-flexion. Prevention of instability through proper bone cuts and soft tissue balancing is emphasized.
Calcaneal fractures
Here are the key steps in the ORIF procedure:
1. Patient is placed in lateral decubitus position and a right-angled lateral incision is made to minimize soft tissue damage.
2. The fracture line at the angle of Gissane is identified.
3. Fragments are temporarily held in place with K-wires under fluoroscopy while the reconstruction restores the 3D shape of the calcaneus.
4. The "constant" sustentacular fragment is used to begin the reconstruction, working anteriorly and medially.
5. Traction may be needed to restore the posterior facet.
6. The lateral wall fragment is closed like a door last to complete the
Ankle arthrodesis
This document provides information on ankle arthrodesis. It begins by describing the anatomy of the ankle joint and its biomechanics. It then discusses indications for ankle arthrodesis including various types of arthritis. Conservative management is outlined followed by details of the surgical procedure including patient evaluation, approaches, fixation methods, post-operative care and alternatives to fusion. Specific techniques like transfibular arthrodesis with a fibular strut graft are explained. The goal of ankle arthrodesis is to fuse the ankle joint to relieve pain from arthritis while maintaining alignment and function.
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Prepare by Dr Shankar jangid..supervised by Dr Prashant modi REFERENCE FROM Philipp Lobenhoffer and Ronald...
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This document discusses tibial pilon fractures, which involve fractures of the distal tibial articular surface. Key points include:
1) The term "tibial pilon" was first used in 1911 to describe the distal tibia resembling a pestle. Pilon fractures account for 7-10% of tibial fractures and usually result from high-energy mechanisms.
2) Classification systems include the Rüedi-Allgöwer system (based on articular displacement/comminution) and the AO/OTA system (which further subdivides based on extra-articular involvement and comminution).
3) Treatment involves restoring tibial alignment, stabilizing the fracture to facilitate union,
Ottopelvis
Otto Pelvis, also known as primary protrusio acetabuli, was first described by German pathologist Otto in 1824. It is characterized by medial protrusion of the acetabulum. There are two types: primary, which remains a diagnosis of exclusion, and secondary. Clinical features include a marked female predilection and bilateral involvement. Radiographs can identify protrusio using Kohler's line or central edge angle. Management depends on age and degeneration, ranging from valgus osteotomy in younger patients to total hip arthroplasty with grafting in older patients. Surgical techniques aim to restore the hip center through lateralization and reconstruction of bone defects.
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Similar to Lisfranc injury
Lisfranc
1) A Lisfranc fracture is a fracture or dislocation of the tarsal bones where they meet the bases of the metatarsal bones in the midfoot.
2) It is usually caused by high-energy twisting injuries or axial loading with the foot fixed. Common mechanisms are falls from heights or motor vehicle accidents.
3) Diagnosis involves x-rays of the foot, and sometimes CT or MRI to further evaluate bone and ligament injuries. Operative treatment is usually needed for displaced fractures to restore the normal alignment of the bones.
Lisfranc injury-
The document discusses Lisfranc injuries, which involve fractures or ligament tears around the tarsometatarsal joint complex of the midfoot. It provides details on the anatomy of the Lisfranc joint and ligaments, classification systems for injuries, mechanisms of injury, clinical and radiographic evaluation methods, and treatment approaches including casting, surgery, and postoperative care. Surgical treatment aims to restore anatomical alignment through open reduction and internal fixation, while nonsurgical treatment is considered for minor injuries with little displacement. Complications can include arthritis, deformity, and hardware issues if not properly treated.
The area known as lisfranc
The Lisfranc joint is located in the midfoot and connects the metatarsals to the tarsus bones. It gets its name from a French surgeon who first described an amputation through this joint. Injuries to the Lisfranc joint are often caused by high-energy trauma that disrupts the normal alignment of the metatarsal bones. Proper diagnosis requires examination and weight-bearing x-rays to assess for displacement or instability. Treatment depends on the severity and stability of the injury, ranging from casting to surgical repair.
Lisfranc injuries
This document discusses Lisfranc injuries, which involve fractures or dislocations of the tarsometatarsal joint complex of the midfoot. It covers the relevant anatomy, mechanisms of injury including twisting, axial loading and crush injuries. Clinical presentation includes midfoot pain and swelling. Classification systems describe the pattern of injury. Imaging with x-rays, CT and MRI can identify fractures and ligament disruptions. Treatment may involve casting or surgical repair and stabilization to restore normal anatomical alignment. Complications can include arthritis, infection and painful hardware.
Lisfranc injuries
1) A Lisfranc injury involves trauma to the tarsometatarsal (TMT) joints of the midfoot, ranging from ligament sprains to fracture dislocations.
2) Diagnosis involves identifying pain and swelling across the midfoot with weight bearing, along with radiographic evidence of malalignment between the metatarsals and tarsals.
3) Treatment depends on the severity of injury - stable injuries are treated conservatively while unstable injuries requiring surgical reduction and fixation to restore anatomical alignment.
Approach to foot x ray.pdf
This document provides guidance on taking and interpreting foot x-rays. It discusses the standard views taken - AP, lateral, and oblique. It describes how to evaluate bones, cartilage, and joints of the foot seen on each view, including the talus, calcaneus, navicular, cuboid, cuneiforms, and metatarsals. Common fractures like Jones fractures of the 5th metatarsal and Lisfranc injuries are explained. Interpretation of the calcaneal-cuboid angle and Lisfranc ligament integrity are important. Neuropathic conditions like Charcot foot and midfoot injuries such as Chopart fractures are also briefly covered.
Lisfranc injuries
1) A Lisfranc injury involves damage to the ligaments and bones in the midfoot region where the metatarsals connect to the tarsus.
2) It is important to properly diagnose and treat Lisfranc injuries, as untreated or misdiagnosed injuries can lead to long-term functional limitations.
3) Diagnosis involves clinical exam, weight-bearing x-rays, and sometimes advanced imaging like CT or MRI. Surgical treatment aims to restore proper alignment and stabilize the injured joints through open reduction and internal fixation.
Mid foot lisfranc fracture
This document discusses Lisfranc injuries, which involve dislocation of the tarsometatarsal joint complex. It describes the relevant anatomy, mechanisms of injury, classification systems, diagnostic imaging findings, treatment options including closed or open reduction with fixation, and post-operative management. Proper diagnosis requires a high index of suspicion as these injuries can be easily missed. Anatomic reduction and fixation are essential to optimize outcomes.
Lisfranc injuries
This document provides an overview of Lisfranc injuries, which involve the tarsometatarsal joint complex connecting the midfoot and forefoot. It describes the relevant anatomy, including the key Lisfranc ligament. Common mechanisms of injury are sports-related or high-energy trauma causing hyperextension or plantarflexion. Clinical presentation involves midfoot pain and swelling. Diagnosis relies on imaging like x-rays showing bone displacement. Injuries are classified based on the direction of metatarsal displacement. Treatment options include closed reduction for minor injuries or open reduction with internal fixation for severe fractures or dislocations.
Ankle injuries by sunil
common injuries of foot and ankle in sports and common during activity, overview of foot and ankle injuries.
L16_Midfoot_fx_2011_Jones.ppt
This document provides an overview of midfoot fractures and dislocations, including:
- Midfoot anatomy, mechanisms of injury, foot function and shape, and treatment principles.
- Details on midfoot crush injuries, forefoot crush injuries including Lisfranc joint injuries - their diagnosis, treatment, and outcomes.
- Discussions around prognosis, complications, and debates around primary arthrodesis versus open reduction and internal fixation for Lisfranc injuries.
fracture It femur
This document provides information on intertrochanteric fractures of the femur. It discusses the history, epidemiology, risk factors, anatomy, mechanisms of injury, classification systems, evaluation, and treatment options. Intertrochanteric fractures occur in the region between the greater and lesser trochanters and may extend into the subtrochanteric region. Treatment options include non-operative management with traction or operative fixation with devices like the dynamic hip screw, cephalomedullary nails, or plates. Classification systems help determine fracture stability and appropriate treatment.
Lisfranc injury in orhopaedics and traumatologypptx
A 33-year-old male presented to the emergency department with a swollen left foot after a metal cabinet fell on it. Imaging showed a Lisfranc fracture-dislocation of the left foot involving displacement of the first through fifth metatarsals. The patient underwent open reduction and internal fixation with cannulated screws to anatomically reduce the joints. Post-operatively, the foot was placed in a cast for 8-12 weeks to allow stabilization before beginning protected weight bearing and use of orthotics. ORIF provides improved stability and mobility outcomes compared to arthrodesis, though both are acceptable treatment options for Lisfranc injuries.
Wrist injuries
The document discusses common wrist injuries including fractures of the scaphoid and hook of hamate bones, de Quervain's tenosynovitis, injuries to the distal radial epiphysis, triangular fibrocartilage complex tears, Kienböck's disease, carpal tunnel syndrome, and ulnar nerve compression. Many of these injuries occur due to falls on an outstretched hand or repetitive stresses from sports activities. Clinical exams and imaging tests can help diagnose specific injuries, which are often initially treated conservatively with rest, splinting, or injections but may require surgery in some cases.
Knee 2
This document provides an overview of MRI protocols and findings for evaluating knee injuries. It describes various pulse sequences used to image the knee, including T1, T2, gradient echo, and STIR. Key areas evaluated by MRI are listed as the menisci, ligaments, tendons, bones, and effusion. Common meniscal injuries like tears, degeneration, discoid meniscus, and cysts are depicted along with signs. Ligament injuries of the ACL, PCL, collateral and retinacular ligaments are shown. Primary signs within the ligament and secondary signs outside the ligament are defined for ACL tears. Partial ACL tears can be subtle to detect. Overall, the document serves
Ankle instability
This document discusses ankle instability and chronic ankle sprains. It begins by describing the anatomy of the ankle joint and its ligaments. It then explains that ankle sprains are common injuries, often caused by an inversion mechanism. Chronic ankle instability can develop after repeated sprains and is characterized by recurrent sprains, pain, and a feeling of the ankle giving way. Treatment of ankle sprains focuses on RICE initially, followed by bracing and physical therapy to improve strength, range of motion and proprioception. Surgery is rarely needed except for severe, unresolving cases.
Musculoskeletal Injuries
This document discusses musculoskeletal injuries, including identifying open and closed extremity injuries. It covers splinting injured extremities, with purposes of splinting being to minimize complications and prevent motion of bone fragments and ends. General rules of splinting include immobilizing joints above and below injuries, padding splints, and telling EMTs to immobilize patients where they lie, not as they lie. Types of splinting discussed include long-bone splinting, joint immobilization, pelvic injuries, traction splinting, and pelvic wraps.
Injuries around the ankle by Dr Bipul Borthakur ppt
This document provides an overview of common ankle injuries. It begins with learning objectives and topics to be covered related to ankle anatomy, fractures, ligament injuries, and tendon injuries. It then describes the anatomy of the ankle joint and its ligaments in detail. It discusses the mechanisms, classifications, clinical evaluation, and treatment approaches for fractures, ligament sprains, tendon ruptures, and other ankle injuries. Surgical and non-surgical treatment options are presented, along with potential complications. The goal of treatment is described as anatomic restoration of the ankle joint and restoration of fibular length and rotation when necessary.
hand injuries in sports
The document summarizes various common wrist, hand and finger injuries seen in athletes. It describes injuries such as scaphoid fractures, triangular fibrocartilage complex tears, de Quervain's tenosynovitis, mallet finger and boutonniere deformity. For each injury, it discusses mechanisms of injury, clinical findings, investigations and treatment options.
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Lisfranc injury
- 2. Lisfranc injuries, also called Lisfranc fracture- dislocations, are the most common type of dislocation involving the foot and correspond to the dislocation of the articulation of the tarsus with the metatarsal bases
- 3. Jacques Lisfranc de St. Martin (April 2, 1790 – May 13, 1847) LISFRANC IS NAMED AFTER THIS FRENCH SURGEON, WHO SERVED IN THE NAPOLEONIC ARMY IN THE 1800S.
- 4. Lisfranc joint complex consists of three articulations including Tarsometatarsal articulation. Intermetatarsal articulation. Intertarsal articulations.
- 5. Mechanism of Injury Direct Injury Indirect Injury
- 6. Clinical Findings Midfoot pain with difficult in weight bearing. Swelling across the dorsum of th foot. Deformity variable due to possible spontaneous reduction.
- 7. There may be bruising on both the top and bottom of the foot. Bruising on the bottom of the foot is highly suggestive of a Lisfranc injury.( Planter Ecchymosis Sign)
- 8. Pain with a stress examination of the midfoot. Examinor may grasp your heel and twist the front of your foot to determine whether there is pain at the midfoot. This should not cause pain in your uninjured foot. Pain with a "piano key" test. Examinor may grasp your toes and move them up and down to determine whether this causes pain. This puts stress across the midfoot and will produce pain if there is an injury
- 9. RADIOGRAPHIC EVALUATION Xrays Computed tomography (CT) scan. MRI Bone Scans UltraSound scan
- 10. Radiographic Evaluation AP: The medial margin of the 2nd metatarsal base and medial margin of the medial cuneiform should be alligned
- 11. Oblique: Medial base of the 4th metatarsal and medial margin of the cuboid should be Alligned
- 12. AP View Xrays
- 15. A “fleck sign” should be sought in the medial cuneiform– second metatarsal space. This represents an avulsion of the Lisfranc ligament.
- 16. MRI MRI has an advantage in identifying partial ligament injuries. Especially useful in low velocity injuries and in settings of Normal radiographs of ligament injuries.
- 17. Management Nonsurgical Treatment Surgical Treatment
- 18. Nonsurgical Treatment If there are no fractures or dislocations in the joint and the ligaments are not completely torn, nonsurgical treatment may be all that is necessary for healing wearing a non-weightbearing cast or boot for 6 week must be very strict about not putting weight on your injured foot during this period. follow up with you regularly and take additional x-rays to make sure your foot is healing well.
- 19. Surgical Treatment The goal of surgical treatment is to realign the joints and return the broken (fractured) bone fragments to a normal position Use Internal fixation for the bones are positioned correctly
- 20. THANK YOU