Severe open Lisfranc injuries: one-stage operation through internal fixation associated with vacuum sealing drainage.
BACKGROUND
This study aimed to investigate the clinical feasibility of treating severe open Lisfranc injuries by means of one-stage internal fixation with k-wires associated with vacuum sealing drainage (VSD).


METHODS
The clinical outcomes of 20 cases of severe open Lisfranc joint fracture-dislocation treated by using one-stage internal fixation with k-wires associated with VSD, after debridement and suturing during emergency treatment, were reviewed.


RESULTS
At 6 and 12 months after surgery, the American Orthopaedic Foot and Ankle Society midfoot scores were 69.2 and 78.2, the positive rates were 75 and 85 %, and the average visual analogue scale scores were 4.3 and 1.3, respectively. The average time of internal fixation surgery was 47 min (30-70 min). There were three cases of wound-edge necrosis; however, there were no cases of skin necrosis around the incision, or deep infection. The mean time of first hospital stay was 16.1 days (10-23 days).


CONCLUSIONS
Treatment of severe open Lisfranc fracture and dislocation through one-stage internal fixation with k-wires in association with VSD led to fast anatomical reduction, stabilized bony structure, fast soft tissue recovery, and good short-term follow-up results.
Department of Orthopaedics and Trauma, Yantaishan Hospital, Yantai, 264008, China.
Wenqing
W
Qu
Department of Orthopaedics and Trauma, Yantaishan Hospital, Yantai, 264008, China.
Shuqin
S
Ni
Department of Orthopaedics and Trauma, Yantaishan Hospital, Yantai, 264008, China.
Zhenhai
Z
Wang
Department of Orthopaedics and Trauma, Yantaishan Hospital, Yantai, 264008, China.
Yong
Y
Zhao
Department of Orthopaedics, Yangpu Hospital of Tongji University, Shanghai, 200090, China.
Shimin
S
Zhang
Department of Orthopaedics and Trauma, Yantaishan Hospital, Yantai, 264008, China.
Yiheng
Y
Cheng
Department of Orthopaedics and Trauma, Yantaishan Hospital, Yantai, 264008, China.
Tong
T
Liu
Department of Orthopaedics and Trauma, Yantaishan Hospital, Yantai, 264008, China.
Min
M
Yu
Department of Orthopaedics and Trauma, Yantaishan Hospital, Yantai, 264008, China. danwangdoc@126.com.
Dan
D
Wang
D000328:Adult; D000368:Aged; D003646:Debridement / Q000379:methods; D004322:Drainage / Q000379:methods; D005240:Feasibility Studies; D005260:Female; D018409:Foot Injuries / Q000601:surgery*; D005593:Fracture Fixation, Internal; D005597:Fractures, Open / Q000601:surgery*; D006801:Humans; D004204:Joint Dislocations / Q000601:surgery*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D054843:Negative-Pressure Wound Therapy / Q000379:methods; D061646:Operative Time; D016896:Treatment Outcome; D058106:Wound Closure Techniques; D055815:Young Adult
Lisfranc joints injury; Openness; VSD; k-wire internal fixation