Anatomic predisposition to ligamentous lisfranc injury

A matched case-control study

Sean M. Gallagher, Noe A. Rodriguez, Clark R. Andersen, William M. Granberry, Vinod Panchbhavi

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Background: Subtle, or ligamentous, Lisfranc injuries occur following low-energy trauma to the midfoot and can be debilitating. Since they are ligamentous, they may not heal, requiring arthrodesis in some cases. Certain mortise anatomic characteristics on radiographs have been shown to be associated with a predisposition to the ligamentous subtype of Lisfranc injuries. It is not known whether there are other morphometric characteristics, such as arch height or the relative length of the second metatarsal, that can similarly influence the predisposition to these injuries. Methods: The present retrospective matched case-control study involved fifty-two control subjects and twenty-six patients with ligamentous Lisfranc injuries treated from 2006 to 2010 at two institutions. Clinical and radiographic data (second metatarsal length relative to foot length, first intermetatarsal angle, navicular-cuboid overlap relative to cuboid vertical height, first metatarsal-talus angle, and calcaneal pitch angle) were examined for the existence of significant differences between control and Lisfranc subjects. Logistic regression analysis was then performed to evaluate potential risk for injury on the basis of these anatomic variables. Results: Compared with matched controls, patients with a ligamentous Lisfranc injury were found to have a significantly smaller ratio of second metatarsal length to foot length (p < 0.001) on weight-bearing radiographs. Conclusions: Occurrence of a ligamentous Lisfranc injury was shown to be associated with a smaller ratio of second metatarsal length to foot length; >50% of patients in the injury group had a ratio of <29%. Level of Evidence: Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.

Original languageEnglish (US)
Pages (from-to)2043-2047
Number of pages5
JournalJournal of Bone and Joint Surgery - Series A
Volume95
Issue number22
DOIs
StatePublished - Nov 20 2013

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Case-Control Studies
Metatarsal Bones
Wounds and Injuries
Foot
Talus
Arthrodesis
Logistic Models
Regression Analysis

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine
  • Medicine(all)

Cite this

Anatomic predisposition to ligamentous lisfranc injury : A matched case-control study. / Gallagher, Sean M.; Rodriguez, Noe A.; Andersen, Clark R.; Granberry, William M.; Panchbhavi, Vinod.

In: Journal of Bone and Joint Surgery - Series A, Vol. 95, No. 22, 20.11.2013, p. 2043-2047.

Research output: Contribution to journalArticle

Gallagher, Sean M. ; Rodriguez, Noe A. ; Andersen, Clark R. ; Granberry, William M. ; Panchbhavi, Vinod. / Anatomic predisposition to ligamentous lisfranc injury : A matched case-control study. In: Journal of Bone and Joint Surgery - Series A. 2013 ; Vol. 95, No. 22. pp. 2043-2047.
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abstract = "Background: Subtle, or ligamentous, Lisfranc injuries occur following low-energy trauma to the midfoot and can be debilitating. Since they are ligamentous, they may not heal, requiring arthrodesis in some cases. Certain mortise anatomic characteristics on radiographs have been shown to be associated with a predisposition to the ligamentous subtype of Lisfranc injuries. It is not known whether there are other morphometric characteristics, such as arch height or the relative length of the second metatarsal, that can similarly influence the predisposition to these injuries. Methods: The present retrospective matched case-control study involved fifty-two control subjects and twenty-six patients with ligamentous Lisfranc injuries treated from 2006 to 2010 at two institutions. Clinical and radiographic data (second metatarsal length relative to foot length, first intermetatarsal angle, navicular-cuboid overlap relative to cuboid vertical height, first metatarsal-talus angle, and calcaneal pitch angle) were examined for the existence of significant differences between control and Lisfranc subjects. Logistic regression analysis was then performed to evaluate potential risk for injury on the basis of these anatomic variables. Results: Compared with matched controls, patients with a ligamentous Lisfranc injury were found to have a significantly smaller ratio of second metatarsal length to foot length (p < 0.001) on weight-bearing radiographs. Conclusions: Occurrence of a ligamentous Lisfranc injury was shown to be associated with a smaller ratio of second metatarsal length to foot length; >50{\%} of patients in the injury group had a ratio of <29{\%}. Level of Evidence: Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.",
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