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Journal of Bone and Joint Surgery - British Volume, Vol 84-B, Issue 7,
981-985.
doi: 10.1302/0301-620X.84B7.12587 Copyright © 2002 by British Editorial Society of Bone and Joint Surgery The anatomy of the joint as a risk factor for Lisfranc dislocation and fracture-dislocationAN ANATOMICAL AND RADIOLOGICAL CASE CONTROL STUDYG. Peicha, MD; J. Labovitz, DPM; F. J. Seibert, MD; and W. Grechenig, MDDepartment of Traumatology A. Weiglein, MD Anatomic Institute K. W. Preidler, MD Department of Radiology F. Quehenberger, DScTech Institute for Statistics and Documentation, University of Graz Medical School, Auenbruggerplatz 7a, A-8036 Graz, Austria. Correspondence should be sent to Dr G. Peicha. The anatomy of the mortise of the Lisfranc joint between the medial and lateral cuneiforms was studied in detail, with particular reference to features which may predispose to injury. In 33 consecutive patients with Lisfranc injuries we measured, from conventional radiographs, the medial depth of the mortise (A), the lateral depth (B) and the length of the second metatarsal (C). MRI was used to confirm the diagnosis. We calculated the mean depth of the mortise (A+B)/2, and the variables of the lever arm as follows: C/A, C/B and C/mean depth. The data were compared with those obtained in 84 cadaver feet with no previous injury of the Lisfranc joint complex. Statistical analysis used Students two-sample t-test at the 5% error level and forward stepwise logistic regression. The mean medial depth of the mortise was found to be significantly less in patients with Lisfranc injuries than in the control group. Stepwise logistic regression identified only this depth as a significant risk factor for Lisfranc injuries. The odds of being in the injury group is 0.52 (approximately half) that of being a control if the medial depth of the mortise is increased by 1 mm, after adjusting for the other variables in the model. Our findings show that the mortise in patients with injuries to the Lisfranc joint is shallower than in the control group and the shallower it is the greater is the risk of injury.
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