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Custom orthotics and physical therapy
1%
17/2498
Closed reduction and percutaneous screw fixation of 1st through 3rd tarsometatarsal joints
2%
51/2498
Open reduction internal fixation of 1st through 3rd tarsometatarsal joints
19%
466/2498
Arthrodesis of 1st through 3rd tarsometatarsal joints
74%
1855/2498
Tarsometatarsal arthrodesis and triple arthrodesis
3%
87/2498
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The clinical presentation and radiographs present a Lisfranc (tarsometatarsal dislocation) injury that is 6 months old. The first, second, and third tarsometatarsal articulations are involved. Given the chronicity of the injury, arthrodesis is the best treatment option available to relieve pain and improve function. There is no indication to include a triple arthrodesis with the tarsometatarsal arthrodesis. The Mulier article compared total arthrodesis (medial + lateral) vs medial column arthrodesis with lateral column ORIF for severe Lisfranc injuries. They found inferior outcomes with total arthrodesis. Komenda et al reviewed 32 patients who underwent tarsometatarsal arthrodesis at a minimum of 6 months following injury. The patients improved significantly compared to the preoperative pain and function. However, a number of complications were encountered including neuritis, malunion, nonunion, wound sloughing, and RSD.
3.7
(21)
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