Severe open Lisfranc injuries: one-stage operation through internal fixation associated with vacuum sealing drainage

J Orthop Surg Res. 2016 Nov 4;11(1):134. doi: 10.1186/s13018-016-0471-1.

Abstract

Background: This study aimed to investigate the clinical feasibility of treating severe open Lisfranc injuries by means of one-stage internal fixation with k-wires associated with vacuum sealing drainage (VSD).

Methods: The clinical outcomes of 20 cases of severe open Lisfranc joint fracture-dislocation treated by using one-stage internal fixation with k-wires associated with VSD, after debridement and suturing during emergency treatment, were reviewed.

Results: At 6 and 12 months after surgery, the American Orthopaedic Foot and Ankle Society midfoot scores were 69.2 and 78.2, the positive rates were 75 and 85 %, and the average visual analogue scale scores were 4.3 and 1.3, respectively. The average time of internal fixation surgery was 47 min (30-70 min). There were three cases of wound-edge necrosis; however, there were no cases of skin necrosis around the incision, or deep infection. The mean time of first hospital stay was 16.1 days (10-23 days).

Conclusions: Treatment of severe open Lisfranc fracture and dislocation through one-stage internal fixation with k-wires in association with VSD led to fast anatomical reduction, stabilized bony structure, fast soft tissue recovery, and good short-term follow-up results.

Keywords: Lisfranc joints injury; Openness; VSD; k-wire internal fixation.

Publication types

  • Evaluation Study

MeSH terms

  • Adult
  • Aged
  • Debridement / methods
  • Drainage / methods
  • Feasibility Studies
  • Female
  • Foot Injuries / surgery*
  • Fracture Fixation, Internal
  • Fractures, Open / surgery*
  • Humans
  • Joint Dislocations / surgery*
  • Length of Stay
  • Male
  • Middle Aged
  • Negative-Pressure Wound Therapy / methods
  • Operative Time
  • Treatment Outcome
  • Wound Closure Techniques*
  • Young Adult