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KMID : 0896719970010020112
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Journal of the Korean Society of Foot Surgery
1997 Volume.1 No. 2 p.112 ~ p.118
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Treatment for Tatsometatarsal Fracture - Dislocation
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Chung Yung-Khee
Park Yong-Wook
Yoon Jung-Han
Noh Dong-Geun
Ha Sung-Han
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Abstract
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Tarsometatarsal fracture-dislocation is uncomrnon but severe lesion. Since this lesion is sometimes difficult to recognize by raentgenography, it is easiJy overlooked. Three pat,ients were t.reated with open reduction and internal fixation with 3.5 mm cannulated screw and K- wire, two had t,reatment with open reduction and intemal fixation with 3.5 mm cannulated screw only and two had treatment with closed reduct.ion and short leg cast. only bet.ween January 1994 and May 1996. The duration of follow up ranged from twelve to twenty nine months after the diagnosis. Results were assessed by a subjective questionnaire, physical examination, and radiographic analysis. Multiple fixation techniques for maintaining the reduction of tar sometatarsl joint have heen introdueed. We recently used the 3.5 mm cannulated screw for int.ernal fixatian of the tarso-first and secand metatarsal fracture dislocation. We think cannulatecl screw fixation has several advantages ; 1. The cannulated screw fixation is more rigid than the K-wire fixation. 2. Ther is an decreased risk of screw breakage with early weight bearing. 3. It is possible to compress the involved joints, if necessary. There were no disability in all patients. One pat.ient ivho was treated with delayed open reduction and internal fixation with 3.5 rnm cannulat.ed screw and K-wire had a radiographic mild degenerat.ive arthritis. And one patient who was treated with closed reduction and short leg cast had a milc. mettarsus adduct.us. But. these t.vo patients were sympt.om free. There was no correlation between t.he severity of the diastasis and the patients functional result.
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KEYWORD
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Tarsometatarsal joint, Fract.ure and dislocation, Treatment
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