Asian Journal of Orthopaedic Research

Complex Lisfranc Fracture: Bidirectional Cuneiform Dislocation with Successful Closed Reduction: A Case Report

Timothy K. Summers *

Department of Orthopaedic Surgery, Medical College of Georgia at Augusta University, Georgia.

Benjamin D. Sookhoo *

Department of Orthopaedic Surgery, Medical College of Georgia at Augusta University, Georgia.

Robert Shelley

Department of Orthopaedic Surgery, Medical College of Georgia at Augusta University, Georgia.

William Rosenblum

Department of Orthopaedic Surgery, Medical College of Georgia at Augusta University, Georgia.

*Author to whom correspondence should be addressed.

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Abstract

Aim: Lisfranc fractures with cuneiform displacement are rare, commonly involving only a single cuneiform dislocation. Literature is limited in multi-cuneiform fracture dislocations. This case report elaborates on treatment of aLisfranc injury with concurrent dorsomedial and plantar dislocations of the medial and intermediate cuneiforms, respectively.

Presentation of Case: A 35-year-old male was diagnosed with a Lisfranc fracture with bidirectional dislocation of the medial and intermediate cuneiforms following a motor vehicle accident. The injury was reduced successfully with manual retraction, midfoot manipulation, and Kirschner wire fixation in the operating studio.

Discussion / Conclusion: Closed reduction and percutaneous pinning are sufficient for reduction in this injury, decreasing morbidity and complications associated with open reduction. Given the nature of our approach, and the distinctiveness of this particular Lisfranc variant, we offer an original methodology to expand on existing literature.

Keywords: Lisfranc injury, lisfranc fracture, cuneiform dislocation, medial cuneiform, intermediate cuneiform.

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