Percutaneous Reduction and Internal Fixation of the Lisfranc Fracture-Dislocation

Abstract

The success of minimally invasive percutaneous reduction and fixation of tarsometatarsal or Lisfranc injuries lies in understanding the appropriate injury pattern for this method of treatment. The eponym Lisfranc dislocation is derived from injuries sustained to cavalry troops in the Napoleonic era. These were associated with significant vascular and soft tissue injury, as they were treated with an amputation through the tarsometatarsal joints by Lisfranc, Napoleon’s surgeon. Although the injuries secondary to equestrian activity have declined, the injury pattern is commonly associated with high-energy motor vehicle accidents, falls, and crushing injuries to the foot.^1–4 These mechanisms typically involve significant bony and soft tissue injury that rarely can be managed by closed methods (Fig. 42.1). Percutaneous fixation is most amenable in those patients with low-energy mechanisms, particularly in the athletic and elderly populations involving primarily a ligamentous injury (Fig. 42.2).