title: Bilateral tarsometatarsal joint injuries: An unusual mechanism producing unusual variants.
abstract: Tarsometatarsal (Lisfranc) joint injuries are rare but potentially devastating conditions requiring anatomical reduction and internal fixation or arthrodesis. We describe an unusual mechanism involving forced eversion and dorsiflexion on both fully supinated feet resulting in bilateral tarsometatarsal joint injury. The injury pattern involved incongruity between the medial and middle columns extending between the cuneiform bones with associated fracture of the cuboid on the right and the cuboid, os calcis and talus on the left. Operative fixation is discussed and the clinical outcome was good at 4 years post-operatively. We believe this introduces an additional and potentially serious mechanism of injury and pattern of ligamentous and osseous disruption into the pantheon of injuries classed as Lisfranc, which surgeons should be aware of. Furthermore, we recommend attention to the mechanism of injury in consideration with classification to aid in operative reduction and fixation.
authors.affiliation: Glasgow Royal Infirmary, 84 Castle Street, Glasgow G4 0SF, UK. Electronic address: peteryoung2@nhs.net.
authors.forename: P S
authors.initials: PS
authors.lastname: Young
authors.affiliation: Glasgow Royal Infirmary, 84 Castle Street, Glasgow G4 0SF, UK. Electronic address: giniclement@gmail.com.
authors.forename: V L
authors.initials: VL
authors.lastname: Clement
authors.affiliation: Glasgow Royal Infirmary, 84 Castle Street, Glasgow G4 0SF, UK. Electronic address: adam@adamlomax.wanadoo.co.uk.
authors.forename: A
authors.initials: A
authors.lastname: Lomax
authors.affiliation: Glasgow Royal Infirmary, 84 Castle Street, Glasgow G4 0SF, UK. Electronic address: jaswant@doctors.org.uk.
authors.forename: J
authors.initials: J
authors.lastname: Badhesha
authors.affiliation: Hairmyres Hospital, Eaglesham Rd, East Kilbride G75 8RG, UK. Electronic address: rosmiller@doctors.org.uk.
authors.forename: R J
authors.initials: RJ
authors.lastname: Miller
authors.affiliation: Glasgow Royal Infirmary, 84 Castle Street, Glasgow G4 0SF, UK. Electronic address: ashish.mahendra@ggc.scot.nhs.uk.
authors.forename: A
authors.initials: A
authors.lastname: Mahendra
mesh_terms: D000328:Adult; D005260:Female; D033023:Foot Joints / Q000293:injuries*; D005593:Fracture Fixation, Internal; D018460:Fractures, Comminuted / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D006801:Humans; D057072:Intra-Articular Fractures / Q000175:diagnosis* / Q000209:etiology* / Q000601:surgery; D013639:Tarsal Bones / Q000293:injuries*
keywords: Fracture fixation; Hyperdorsiflexion; Lisfranc injury; Tarsometatarsal joint