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Review Question - QID 6764

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QID 6764 (Type "6764" in App Search)
A 26-year-old rugby player injured his foot when tackled from behind. Radiographs are seen in Figures 35a through 35c. What is the most appropriate treatment?
  • A
  • B
  • C

Closed reduction and percutaneous pin fixation

3%

19/660

Application of a short leg non-weight-bearing cast

2%

12/660

Application of a walking boot with weight bearing as tolerated

2%

12/660

Open reduction and internal fixation

92%

604/660

Elastic bandage wrap and activity as tolerated

1%

7/660

  • A
  • B
  • C

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The patient has a ligamentous Lisfranc injury. Diastasis seen between the bases of the second metatarsal and medial cuneiform is pathognomonic for a rupture of the Lisfranc’s ligament. This injury is best treated surgically with either open reduction and internal fixation or possibly closed manipulation and percutaneous screw fixation if anatomic alignment can be achieved closed. Pin fixation has been shown to be inferior to screw fixation due to the length of time that fixation is required for adequate ligament healing.

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