Dorsal multiple plating without routine transarticular screws for fixation of Lisfranc injury.

Abstract

Following a Lisfranc joint injury, stable fixation of the tarsometatarsal joints is crucial to avoid deformity and posttraumatic osteoarthritis, but the ideal method of fixation remains controversial. Kirschner wire (K-wire) fixation of all involved joints with cast immobilization resulted in loss of position, and was replaced by open reduction with improved fixation using transarticular screws. However, it seems intuitive that transarticular screws will result in further damage to already traumatized joints, and this has led to plate-spanning techniques. The objective of this study was to describe the method of dorsal multiple plating without the routine use of transarticular screws, and to report on the ability of plate fixation to maintain alignment comparable to that of transarticular screw fixation in 15 patients.