Do-Yeon Kim1, Jong-Kil Kim2, Min-Woo Kim2, Kwang Bok Lee3. 1. Yeon Orthopaedic Clinic. 2. Department of Orthopaedic Surgery, Presbyterian Medical Center. 3. Department of Orthopedic Surgery, Jeonbuk National University Medical School, Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, South Korea.
Abstract
RATIONALE: Lisfranc injuries are a dislocation of the metatarsal bones from the tarsal bone. Although closed reduction is possible in most cases of Lisfranc injury when attempted in the early stage, there are some rare cases for which open reduction is required. Herein we report a case of irreducible Lisfranc injury in a 34-year-old man who presented to our institution with painful swelling. PATIENT CONCERNS: We report a 34-year-old man presented to our institution with painful swelling after a fall from 1.0 m height. DIAGNOSES: We diagnosed it as irreducible Lisfranc injury by tibialis anterior tendon entrapment through plain radiologic study and surgical findings. INTERVENTIONS: Plain X-ray, C-arm fluoroscopy and open surgery were performed. OUTCOMES: We did a closed reduction under a C-arm fluoroscopic guide, but it was not successful. Thus, we had to do an open reduction of a Lisfranc dislocation. Upon exposure, we observed the entrapment of the tibialis anterior tendon between the medial and intermediate cuneiform bones. LESSONS: Our report is valuable in that it can contribute to the diagnosis and suggest a clue to the treatment of such a rare pathology. The knowledge in the rare case of entrapment of the tibialis tendon and the understanding of management will be useful when a irreducible Lisfranc dislocation is unsuccessful after an attempt at closed reduction.
RATIONALE: Lisfranc injuries are a dislocation of the metatarsal bones from the tarsal bone. Although closed reduction is possible in most cases of Lisfranc injury when attempted in the early stage, there are some rare cases for which open reduction is required. Herein we report a case of irreducible Lisfranc injury in a 34-year-old man who presented to our institution with painful swelling. PATIENT CONCERNS: We report a 34-year-old man presented to our institution with painful swelling after a fall from 1.0 m height. DIAGNOSES: We diagnosed it as irreducible Lisfranc injury by tibialis anterior tendon entrapment through plain radiologic study and surgical findings. INTERVENTIONS: Plain X-ray, C-arm fluoroscopy and open surgery were performed. OUTCOMES: We did a closed reduction under a C-arm fluoroscopic guide, but it was not successful. Thus, we had to do an open reduction of a Lisfranc dislocation. Upon exposure, we observed the entrapment of the tibialis anterior tendon between the medial and intermediate cuneiform bones. LESSONS: Our report is valuable in that it can contribute to the diagnosis and suggest a clue to the treatment of such a rare pathology. The knowledge in the rare case of entrapment of the tibialis tendon and the understanding of management will be useful when a irreducible Lisfranc dislocation is unsuccessful after an attempt at closed reduction.
Authors: Simon Lau; Nicholas Howells; Michael Millar; Daniel De Villiers; Samuel Joseph; Andrew Oppy Journal: J Foot Ankle Surg Date: 2016-04-12 Impact factor: 1.286