[Anatomical reconstruction of chronically instable Lisfranc's ligaments].

BACKGROUND: From June 2001 to May 2013 four selected patients with an isolated and old Lisfranc's ligament rupture were treated at the Trauma Department of the University Hospital Carl Gustav Carus in Dresden with an anatomical repair of the ligament using half of the extensor hallucis longus tendon. This kind of graft 7 cm in length was used in three cases and in the fourth case the whole extensor hallucis brevis tendon was used. Of the four patients three were female with an average age of 28.6 years (range 15-39 years). The fourth patient was a 23-year-old male who was followed up for only 3 months due to emigration abroad. The three female patients were postoperatively followed up for a minimum of 1 year clinically and at the 1 year follow-up all three women had a stable Lisfranc's joint, two were absolutely pain free and one was relatively pain free.
RESULTS: The youngest of the three females was 15 years old at the time of surgery and in preparation for the Olympic Games as a gymnast. This gave rise to the idea for an anatomical repair to avoid partial fusion of the Lisfranc's joint in this very young and extremely competitive sportswoman. The Lisfranc's joint was completely stable and pain free 2 years postoperatively and 10 years after surgery she qualified for the 2005 World Championships in Australia and the Olympic Games in Beijing in 2008.