Anatomic Morphology of the Lisfranc Joint Line - Risk Factor for Fractures and Fracture Dislocations?

G. Peicha; P. Tesch; F. Fankhauser; G. Windisch; F. J. Seibert; W. Grechenig

doi:10.1055/s-2003-42315

Osteosynthesis and Trauma Care, Table of Contents

Osteosynthesis and Trauma Care 2003; 11: 134-137
DOI: 10.1055/s-2003-42315

Varia

Anatomic Morphology of the Lisfranc Joint Line - Risk Factor for Fractures and Fracture Dislocations?

G. Peicha¹ , P. Tesch² , F. Fankhauser¹ , G. Windisch² , F. J. Seibert¹ , W. Grechenig¹

¹Department of Traumatology, University of Graz, Medical School, Graz, Austria
²Anatomic Institute, University of Graz, Medical School, Graz, Austria

Abstract

Aim of the study was to evaluate the anatomic morphology of the “mortise ” of the Lisfranc joint between the medial and lateral cuneiforms and to determine a risk factor for Lisfranc injuries. The following data were obtained in 33 patients with confirmed Lisfranc injuries through evaluation of conventional radiographs: A (medial depth of the mortise), B (lateral depth), C (length of the second metatarsal). Subsequently, we calculated the mean depth of the mortise, (A + B)/2, and the coefficients of the lever arm as follows: C/A, C/B, and C/mean depth. The data was compared to the data obtained in 84 cadaver feet with no pre-existing injury of the Lisfranc joint complex.

The data was statistically evaluated using Student's two-sample t-test and forward stepwise logistic regression. Medial mortise depth “A ”, and all coefficients containing “A”, showed statistically significant differences between the injured cases and the cadaveric control group. The mortise had significantly less depth in patients with confirmed Lisfranc injuries than in the control group. Stepwise logistic regression identified only depth A as a relevant risk factor for Lisfranc injuries. The odds of being a case (i. e., sustaining a fracture) are decreased by 0.52 for every 1 mm increase in the medial depth of the mortise. We conclude that the mortise in patients with injuries to the Lisfranc joint is more shallow than in the control group and that this population group is anatomically predisposed for Lisfranc fracture-dislocation injuries. The shallower the mortise the greater is the risk of injury to the Lisfranc joint.

Key words

Lisfranc joint - anatomy - joint mortise - risk of injury

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Univ.-Doz. Dr. G. Peicha

University of Graz, Medical School · Department of Traumatology

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Austria

Phone: +43/3 16 38 58 12 71

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Email: gerolf.peicha@kfunigraz.ac.at