Podcast
Questions and Answers
What is a common imaging modality to detect injuries to the tarsometatarsal joint complex?
What is a common imaging modality to detect injuries to the tarsometatarsal joint complex?
- Endoscopy
- MRI (correct)
- X-ray (correct)
- Ultrasound
Which type of tarsometatarsal injury typically requires surgical intervention?
Which type of tarsometatarsal injury typically requires surgical intervention?
- Stable injuries
- All unstable injuries (correct)
- Chronic deformities
- Acute fractures
What is one of the purposes of understanding the anatomy and mechanisms of tarsometatarsal injuries?
What is one of the purposes of understanding the anatomy and mechanisms of tarsometatarsal injuries?
- To develop preventative measures for athletes
- To assess treatment options and prognosis (correct)
- To minimize rehabilitation time
- To create new imaging techniques
Which type of injury may be treated conservatively?
Which type of injury may be treated conservatively?
What is a potential outcome of injuries to the tarsometatarsal joint complex?
What is a potential outcome of injuries to the tarsometatarsal joint complex?
Which publication specifically addresses the epidemiology of foot and ankle injuries in sports?
Which publication specifically addresses the epidemiology of foot and ankle injuries in sports?
What factor is primarily considered when diagnosing tarsometatarsal injuries?
What factor is primarily considered when diagnosing tarsometatarsal injuries?
What is the consequence of not correctly diagnosing a tarsometatarsal injury?
What is the consequence of not correctly diagnosing a tarsometatarsal injury?
Which ligament is specifically described as being absent between the first and second metatarsals?
Which ligament is specifically described as being absent between the first and second metatarsals?
What is the primary direction in which dislocations occur in the Lisfranc joint complex?
What is the primary direction in which dislocations occur in the Lisfranc joint complex?
Which ligament arises from the lateral surface of the medial cuneiform?
Which ligament arises from the lateral surface of the medial cuneiform?
Among the ligaments, which type is described as being stronger in the plantar aspect compared to the dorsal aspect?
Among the ligaments, which type is described as being stronger in the plantar aspect compared to the dorsal aspect?
How many TMT ligaments are noted in the Lisfranc joint complex?
How many TMT ligaments are noted in the Lisfranc joint complex?
What is the relationship between the intertarsal dorsal ligaments and the cuneiforms and cuboid?
What is the relationship between the intertarsal dorsal ligaments and the cuneiforms and cuboid?
Which ligament is stated to be the strongest of the plantar ligaments?
Which ligament is stated to be the strongest of the plantar ligaments?
Which statement correctly describes the strength comparison between medial and lateral ligaments in the Lisfranc complex?
Which statement correctly describes the strength comparison between medial and lateral ligaments in the Lisfranc complex?
What is the recommended imaging technique for patients with equivocal findings on non-weight bearing (NWB) radiographs?
What is the recommended imaging technique for patients with equivocal findings on non-weight bearing (NWB) radiographs?
For which stage of Lisfranc injury is nonoperative treatment primarily indicated?
For which stage of Lisfranc injury is nonoperative treatment primarily indicated?
What is the primary goal in managing a Lisfranc injury?
What is the primary goal in managing a Lisfranc injury?
When should stress radiographs under anesthesia be considered?
When should stress radiographs under anesthesia be considered?
What management approach is recommended for unstable Lisfranc injuries?
What management approach is recommended for unstable Lisfranc injuries?
What indicates that a patient may be treated nonsurgically for a Lisfranc injury?
What indicates that a patient may be treated nonsurgically for a Lisfranc injury?
What is crucial to rule out occult instability two weeks after initial presentation?
What is crucial to rule out occult instability two weeks after initial presentation?
What should patients with stable Lisfranc injuries initially receive to protect the soft tissues?
What should patients with stable Lisfranc injuries initially receive to protect the soft tissues?
What is a key advantage of CT imaging over MR imaging in evaluating fractures?
What is a key advantage of CT imaging over MR imaging in evaluating fractures?
In which scenario is it recommended to use CT imaging?
In which scenario is it recommended to use CT imaging?
What might MR imaging mistakenly misinterpret in a fracture assessment?
What might MR imaging mistakenly misinterpret in a fracture assessment?
What imaging technique is beneficial for preoperative surgical planning in complex fractures?
What imaging technique is beneficial for preoperative surgical planning in complex fractures?
What is the ideal orientation for the CT beam angle when imaging the injured foot?
What is the ideal orientation for the CT beam angle when imaging the injured foot?
What could be the significance of tarsometatarsal malalignment seen on MR imaging without other abnormalities?
What could be the significance of tarsometatarsal malalignment seen on MR imaging without other abnormalities?
Which imaging technique is superior for direct visualization of soft tissue structures?
Which imaging technique is superior for direct visualization of soft tissue structures?
Which imaging sequence is recommended to assess complicated fractures that may not be easily identifiable?
Which imaging sequence is recommended to assess complicated fractures that may not be easily identifiable?
What is the primary focus of Myerson et al.'s 1986 study?
What is the primary focus of Myerson et al.'s 1986 study?
Which sign is associated with diagnosing Lisfranc tarsometatarsal injuries?
Which sign is associated with diagnosing Lisfranc tarsometatarsal injuries?
Which imaging technique was highlighted for evaluating Lisfranc joint diastasis according to Panchbhavi et al.?
Which imaging technique was highlighted for evaluating Lisfranc joint diastasis according to Panchbhavi et al.?
What type of joint injuries does Hatem focus on in his 2008 publication?
What type of joint injuries does Hatem focus on in his 2008 publication?
What aspect of Lisfranc injuries is emphasized in the systematic review by Stavlas et al.?
What aspect of Lisfranc injuries is emphasized in the systematic review by Stavlas et al.?
Which medical journal published the study by Lau et al. on Lisfranc fracture dislocation?
Which medical journal published the study by Lau et al. on Lisfranc fracture dislocation?
What diagnostic technique is associated with identifying subtle tarsometatarsal pathology?
What diagnostic technique is associated with identifying subtle tarsometatarsal pathology?
What does the study by Gupta et al. focus on regarding Lisfranc injuries?
What does the study by Gupta et al. focus on regarding Lisfranc injuries?
What imaging technique was specifically evaluated for the Lisfranc ligament in cadaveric feet?
What imaging technique was specifically evaluated for the Lisfranc ligament in cadaveric feet?
Which study discusses the prediction of midfoot instability in subtle Lisfranc injuries?
Which study discusses the prediction of midfoot instability in subtle Lisfranc injuries?
Which treatment method was compared with primary arthrodesis for ligamentous Lisfranc joint injuries?
Which treatment method was compared with primary arthrodesis for ligamentous Lisfranc joint injuries?
What biomechanical analysis was conducted regarding Lisfranc injury fixation devices?
What biomechanical analysis was conducted regarding Lisfranc injury fixation devices?
In which year was the biomechanical analysis of a tensioned suture device published?
In which year was the biomechanical analysis of a tensioned suture device published?
Which option correctly identifies the study that evaluates outcomes after open reduction and internal fixation of Lisfranc joint injuries?
Which option correctly identifies the study that evaluates outcomes after open reduction and internal fixation of Lisfranc joint injuries?
What is the focus of the research by Alberta FG et al. regarding Lisfranc joint injuries?
What is the focus of the research by Alberta FG et al. regarding Lisfranc joint injuries?
Which study addresses the treatment of primarily ligamentous Lisfranc injuries?
Which study addresses the treatment of primarily ligamentous Lisfranc injuries?
What type of injuries typically result from high-energy direct force applied to the dorsum of the foot?
What type of injuries typically result from high-energy direct force applied to the dorsum of the foot?
Which group classified athletic midfoot injuries based on clinical findings and radiographs?
Which group classified athletic midfoot injuries based on clinical findings and radiographs?
What typically characterizes indirect injuries to the midfoot?
What typically characterizes indirect injuries to the midfoot?
What is a noted challenge in diagnosing low-energy Lisfranc injuries?
What is a noted challenge in diagnosing low-energy Lisfranc injuries?
According to the classifications mentioned, which type of Lisfranc injuries is characterized by metatarsal displacement?
According to the classifications mentioned, which type of Lisfranc injuries is characterized by metatarsal displacement?
What type of injuries are associated with multiple atypical tarsal fractures and extensive soft tissue injuries?
What type of injuries are associated with multiple atypical tarsal fractures and extensive soft tissue injuries?
What is a significant factor distinguishing high-energy crush injuries?
What is a significant factor distinguishing high-energy crush injuries?
Which classification system is not useful for low-energy injuries without fractures?
Which classification system is not useful for low-energy injuries without fractures?
What is the main reason CT is preferred in assessing midfoot injuries from high-energy trauma?
What is the main reason CT is preferred in assessing midfoot injuries from high-energy trauma?
In what scenario might MR imaging misidentify avulsion fractures?
In what scenario might MR imaging misidentify avulsion fractures?
What is a potential limitation of MR imaging when assessing midfoot injuries?
What is a potential limitation of MR imaging when assessing midfoot injuries?
Why is a small field of view recommended when performing imaging for midfoot injuries?
Why is a small field of view recommended when performing imaging for midfoot injuries?
Which imaging technique is specifically beneficial for preoperative surgical planning in complex fractures?
Which imaging technique is specifically beneficial for preoperative surgical planning in complex fractures?
What is the effect of the CT beam angle orientation when imaging the injured foot?
What is the effect of the CT beam angle orientation when imaging the injured foot?
What is a common limitation of using MR imaging compared to CT in fracture detection?
What is a common limitation of using MR imaging compared to CT in fracture detection?
What is a key aspect of performing imaging to visualize the ligament complex in the injured foot?
What is a key aspect of performing imaging to visualize the ligament complex in the injured foot?
What imaging technique has been found to reveal significantly more fractures in the metatarsals when compared to traditional radiography?
What imaging technique has been found to reveal significantly more fractures in the metatarsals when compared to traditional radiography?
What is the expected recovery time from a nonoperative Lisfranc injury?
What is the expected recovery time from a nonoperative Lisfranc injury?
What is considered abnormal in abduction stress radiographs if the diastasis exceeds how many millimeters?
What is considered abnormal in abduction stress radiographs if the diastasis exceeds how many millimeters?
In what situation is surgical intervention indicated for foot injuries?
In what situation is surgical intervention indicated for foot injuries?
Why are stress radiographs typically performed under anesthesia?
Why are stress radiographs typically performed under anesthesia?
In the context of Lisfranc injuries, what does a normal finding on weight-bearing radiographs still warrant?
In the context of Lisfranc injuries, what does a normal finding on weight-bearing radiographs still warrant?
What can lead to the failure of closed reduction in foot injuries?
What can lead to the failure of closed reduction in foot injuries?
What surgical method is reported to best restore anatomical reduction for subtle Lisfranc injuries?
What surgical method is reported to best restore anatomical reduction for subtle Lisfranc injuries?
Which finding on imaging is indicative of instability in Lisfranc injuries?
Which finding on imaging is indicative of instability in Lisfranc injuries?
What type of imaging modality may be indicated for assessing occult foot injuries?
What type of imaging modality may be indicated for assessing occult foot injuries?
What advantage does computed tomography (CT) have over standard radiography in the evaluation of foot injuries?
What advantage does computed tomography (CT) have over standard radiography in the evaluation of foot injuries?
What specific circumstance should prompt the use of stress radiographs after initial imaging?
What specific circumstance should prompt the use of stress radiographs after initial imaging?
Which surgical method utilizes fluoroscopic visualization?
Which surgical method utilizes fluoroscopic visualization?
What is a common characteristic of unstable Lisfranc injuries?
What is a common characteristic of unstable Lisfranc injuries?
What is a key outcome from a study that contrasts findings of CT versus radiography in foot fractures?
What is a key outcome from a study that contrasts findings of CT versus radiography in foot fractures?
Which type of fixation method can be used after closed reduction fails?
Which type of fixation method can be used after closed reduction fails?
What type of imaging technique is advantageous for identifying the severity of tarsometatarsal injuries?
What type of imaging technique is advantageous for identifying the severity of tarsometatarsal injuries?
Which anatomical understanding is critical for diagnosing tarsometatarsal injuries?
Which anatomical understanding is critical for diagnosing tarsometatarsal injuries?
What is the primary consideration in determining the treatment approach for tarsometatarsal injuries?
What is the primary consideration in determining the treatment approach for tarsometatarsal injuries?
Which population is indicated for conservatively treating Lisfranc injuries?
Which population is indicated for conservatively treating Lisfranc injuries?
What can advanced imaging modalities, such as CT and MR imaging, provide in the assessment of tarsometatarsal injuries?
What can advanced imaging modalities, such as CT and MR imaging, provide in the assessment of tarsometatarsal injuries?
What outcome is most likely if a tarsometatarsal injury goes undiagnosed?
What outcome is most likely if a tarsometatarsal injury goes undiagnosed?
What alternative imaging technique is mentioned for assessing tarsometatarsal joint injuries?
What alternative imaging technique is mentioned for assessing tarsometatarsal joint injuries?
Which complication is frequently associated with tarsometatarsal joint injuries in athletes?
Which complication is frequently associated with tarsometatarsal joint injuries in athletes?
What is the significance of having a talometatarsal angle greater than 15 degrees in radiographic assessment?
What is the significance of having a talometatarsal angle greater than 15 degrees in radiographic assessment?
Which radiographic finding is most characteristic of Lisfranc injuries?
Which radiographic finding is most characteristic of Lisfranc injuries?
What does the absence of a step-off at the dorsal margins of the TMT joints suggest?
What does the absence of a step-off at the dorsal margins of the TMT joints suggest?
How is the distance between the plantar cortex of C1 and M5 relevant in diagnosing Lisfranc injuries?
How is the distance between the plantar cortex of C1 and M5 relevant in diagnosing Lisfranc injuries?
In an anteroposterior radiograph, what is a concerning finding in terms of the first and second metatarsals?
In an anteroposterior radiograph, what is a concerning finding in terms of the first and second metatarsals?
What does the presence of a bone fragment at C1-M2 in radiographic findings suggest?
What does the presence of a bone fragment at C1-M2 in radiographic findings suggest?
What is the expected measurement for the talometatarsal angle to be considered normal?
What is the expected measurement for the talometatarsal angle to be considered normal?
Which finding indicates a widening greater than 1 mm at M1-M2?
Which finding indicates a widening greater than 1 mm at M1-M2?
What is the primary reason for prompt diagnosis and treatment of a Lisfranc injury?
What is the primary reason for prompt diagnosis and treatment of a Lisfranc injury?
Which mechanism of injury is most commonly associated with Lisfranc injuries?
Which mechanism of injury is most commonly associated with Lisfranc injuries?
What percentage of athletic injuries does Lisfranc injury account for?
What percentage of athletic injuries does Lisfranc injury account for?
Which imaging modality is primarily important for the diagnosis and management of low-energy Lisfranc injuries?
Which imaging modality is primarily important for the diagnosis and management of low-energy Lisfranc injuries?
What should not be classified as a Lisfranc injury?
What should not be classified as a Lisfranc injury?
What is the primary indication for performing stress radiographs under anesthesia for Lisfranc injuries?
What is the primary indication for performing stress radiographs under anesthesia for Lisfranc injuries?
What condition suggests that a patient may be suitable for nonoperative management of a Lisfranc injury?
What condition suggests that a patient may be suitable for nonoperative management of a Lisfranc injury?
Which aspect is crucial for the management of Lisfranc injuries irrespective of injury severity?
Which aspect is crucial for the management of Lisfranc injuries irrespective of injury severity?
What is the role of imaging in assessing patients with equivocal findings on NWB radiographs?
What is the role of imaging in assessing patients with equivocal findings on NWB radiographs?
What differentiates stable from unstable Lisfranc injuries according to Nunley and Vertullo classification?
What differentiates stable from unstable Lisfranc injuries according to Nunley and Vertullo classification?
What is a critical consideration for radiologists when assessing tarsometatarsal injuries?
What is a critical consideration for radiologists when assessing tarsometatarsal injuries?
Which treatment is primarily recommended for unstable injuries in the context of Lisfranc injuries?
Which treatment is primarily recommended for unstable injuries in the context of Lisfranc injuries?
Which imaging modality is often utilized to assess the degree of injury in tarsometatarsal injuries?
Which imaging modality is often utilized to assess the degree of injury in tarsometatarsal injuries?
What is the purpose of performing serial physical examinations after initial Lisfranc injury treatment?
What is the purpose of performing serial physical examinations after initial Lisfranc injury treatment?
What is the primary focus of management strategies for Lisfranc injuries regardless of their classification?
What is the primary focus of management strategies for Lisfranc injuries regardless of their classification?
How do stable tarsometatarsal injuries typically differ from unstable injuries in terms of treatment?
How do stable tarsometatarsal injuries typically differ from unstable injuries in terms of treatment?
What imaging technique is generally deemed superior for the visualization of soft tissue structures?
What imaging technique is generally deemed superior for the visualization of soft tissue structures?
Which condition is associated with the need for surgical intervention in the context of tarsometatarsal injuries?
Which condition is associated with the need for surgical intervention in the context of tarsometatarsal injuries?
What is a potential outcome of improper treatment for tarsometatarsal injuries?
What is a potential outcome of improper treatment for tarsometatarsal injuries?
Which of the following injuries is commonly assessed using conventional radiography in athletic settings?
Which of the following injuries is commonly assessed using conventional radiography in athletic settings?
In terms of managing Lisfranc injuries, which factor is particularly significant to rule out after initial assessment?
In terms of managing Lisfranc injuries, which factor is particularly significant to rule out after initial assessment?
What is the commonly accepted finding on lateral radiographs in cases of Lisfranc injuries?
What is the commonly accepted finding on lateral radiographs in cases of Lisfranc injuries?
What does a talometatarsal angle greater than 15 degrees indicate?
What does a talometatarsal angle greater than 15 degrees indicate?
In a radiographic assessment of Lisfranc injuries, what is the significance of a lateral step-off at the medial margin of the second TMT joint?
In a radiographic assessment of Lisfranc injuries, what is the significance of a lateral step-off at the medial margin of the second TMT joint?
What does a finding of greater than 1 mm of widening of the M1-M2 or C1-C2 joint suggest?
What does a finding of greater than 1 mm of widening of the M1-M2 or C1-C2 joint suggest?
What anatomical structure is involved when assessing the plantar cortex of C1 in relation to M5?
What anatomical structure is involved when assessing the plantar cortex of C1 in relation to M5?
What imaging finding indicates reduced distance between the plantar cortex of C1 and M5?
What imaging finding indicates reduced distance between the plantar cortex of C1 and M5?
Which of the following measurements is considered normal for the talometatarsal angle in healthy individuals?
Which of the following measurements is considered normal for the talometatarsal angle in healthy individuals?
What is the clinical implication of detecting bone fragments at the C1-M2 joint in radiographs?
What is the clinical implication of detecting bone fragments at the C1-M2 joint in radiographs?
What specific advantage does CT imaging have over MR imaging when assessing fractures?
What specific advantage does CT imaging have over MR imaging when assessing fractures?
Which imaging modality is recommended for patients experiencing high-energy midfoot injuries?
Which imaging modality is recommended for patients experiencing high-energy midfoot injuries?
In what context might MR imaging misinterpret a fracture situation?
In what context might MR imaging misinterpret a fracture situation?
What is the uncertainty associated with observed malalignment on MR imaging?
What is the uncertainty associated with observed malalignment on MR imaging?
Which type of imaging plane is considered ideal for assessing the ligament complex of the injured foot?
Which type of imaging plane is considered ideal for assessing the ligament complex of the injured foot?
What imaging technique utilizes three-dimensional volume rendering for complex fracture evaluations?
What imaging technique utilizes three-dimensional volume rendering for complex fracture evaluations?
What imaging technique is helpful to assess for fractures that might be difficult to identify?
What imaging technique is helpful to assess for fractures that might be difficult to identify?
Which imaging characteristic is crucial for evaluating fractures at the midfoot?
Which imaging characteristic is crucial for evaluating fractures at the midfoot?
What is the primary focus of the study by Myerson et al. from 1986?
What is the primary focus of the study by Myerson et al. from 1986?
Which imaging technique is emphasized for assessing Lisfranc joint diastasis?
Which imaging technique is emphasized for assessing Lisfranc joint diastasis?
What clinical sign is highlighted as a diagnostic aid for Lisfranc tarsometatarsal injuries?
What clinical sign is highlighted as a diagnostic aid for Lisfranc tarsometatarsal injuries?
What aspect of Lisfranc fracture-dislocations is discussed in the systematic review by Stavlas et al.?
What aspect of Lisfranc fracture-dislocations is discussed in the systematic review by Stavlas et al.?
Which imaging finding is commonly associated with Lisfranc injuries, as noted by Gupta et al.?
Which imaging finding is commonly associated with Lisfranc injuries, as noted by Gupta et al.?
What type of injury is primarily discussed in the publication by Hatem in 2008?
What type of injury is primarily discussed in the publication by Hatem in 2008?
What clinical aid for diagnosing occult Lisfranc injuries is referred to in the study by Ross et al.?
What clinical aid for diagnosing occult Lisfranc injuries is referred to in the study by Ross et al.?
What is noted about the imaging findings of Lisfranc injuries in the publication by Castro et al.?
What is noted about the imaging findings of Lisfranc injuries in the publication by Castro et al.?
What factor indicates that surgical fixation might be necessary for a Lisfranc injury?
What factor indicates that surgical fixation might be necessary for a Lisfranc injury?
What is the minimum recommended duration for allowing ligamentous healing after a Lisfranc surgical fixation?
What is the minimum recommended duration for allowing ligamentous healing after a Lisfranc surgical fixation?
When should a patient experiencing instability in the midfoot consider using a boot again after a Lisfranc injury?
When should a patient experiencing instability in the midfoot consider using a boot again after a Lisfranc injury?
Which factor can influence the decision to leave surgical hardware in permanently after a Lisfranc injury?
Which factor can influence the decision to leave surgical hardware in permanently after a Lisfranc injury?
For which conditions is external fixation particularly indicated in managing Lisfranc injuries?
For which conditions is external fixation particularly indicated in managing Lisfranc injuries?
What complication can arise from misdiagnosing Lisfranc injuries?
What complication can arise from misdiagnosing Lisfranc injuries?
Which imaging technique is most effective for preoperative surgical planning in complex Lisfranc fractures?
Which imaging technique is most effective for preoperative surgical planning in complex Lisfranc fractures?
What is a potential outcome if a Lisfranc injury is not adequately treated?
What is a potential outcome if a Lisfranc injury is not adequately treated?
What is the significance of the Lisfranc ligament in the tarsometatarsal (TMT) complex?
What is the significance of the Lisfranc ligament in the tarsometatarsal (TMT) complex?
Which of the following describes the interosseous ligaments in the tarsometatarsal joint?
Which of the following describes the interosseous ligaments in the tarsometatarsal joint?
What type of forces commonly cause injuries to the tarsometatarsal joints?
What type of forces commonly cause injuries to the tarsometatarsal joints?
Which of the following best describes the location and structure of the Lisfranc ligament?
Which of the following best describes the location and structure of the Lisfranc ligament?
How do intermetatarsal interosseous ligaments contribute to the stability of the TMT joint?
How do intermetatarsal interosseous ligaments contribute to the stability of the TMT joint?
What is the hallmark feature of a Type C injury in metatarsals?
What is the hallmark feature of a Type C injury in metatarsals?
Which stage of Lisfranc injury is characterized by normal plain films but abnormal bone scans?
Which stage of Lisfranc injury is characterized by normal plain films but abnormal bone scans?
What clinical symptoms are indicative of Stage II Lisfranc injury?
What clinical symptoms are indicative of Stage II Lisfranc injury?
What complication must be considered when severe pain and swelling are present in a foot injury?
What complication must be considered when severe pain and swelling are present in a foot injury?
Which classification type describes total incongruity of the TMT joint in any direction?
Which classification type describes total incongruity of the TMT joint in any direction?
How are Lisfranc injuries categorized according to Nunley and Vertullo?
How are Lisfranc injuries categorized according to Nunley and Vertullo?
What kind of traction is observed in a Stage I Lisfranc injury?
What kind of traction is observed in a Stage I Lisfranc injury?
Which stage of injury is described as having complete disruption of the Lisfranc ligament complex?
Which stage of injury is described as having complete disruption of the Lisfranc ligament complex?
Which structure is crucial for maintaining coronal plane stability in the TMT joint complex?
Which structure is crucial for maintaining coronal plane stability in the TMT joint complex?
Which column of the midfoot is characterized as the least mobile?
Which column of the midfoot is characterized as the least mobile?
What configuration of the second metatarsal base aids in resisting shear forces?
What configuration of the second metatarsal base aids in resisting shear forces?
Which aspect of the Lisfranc joint contributes to its importance during a normal gait pattern?
Which aspect of the Lisfranc joint contributes to its importance during a normal gait pattern?
Which metatarsal column is described as the most mobile?
Which metatarsal column is described as the most mobile?
What is the primary role of the Lisfranc joint within the foot?
What is the primary role of the Lisfranc joint within the foot?
Which of the following structures is not part of the Lisfranc joint complex?
Which of the following structures is not part of the Lisfranc joint complex?
What characteristic feature of the TMT articulations allows for transition in the transverse plane?
What characteristic feature of the TMT articulations allows for transition in the transverse plane?
What is an indication for surgical intervention in open injuries?
What is an indication for surgical intervention in open injuries?
What is the maximum acceptable gap between the medial cuneiform and second metatarsal in a normal alignment?
What is the maximum acceptable gap between the medial cuneiform and second metatarsal in a normal alignment?
Which of the following pairs of structures should align on the AP view to indicate normal alignment?
Which of the following pairs of structures should align on the AP view to indicate normal alignment?
What is a commonly missed injury of the midfoot?
What is a commonly missed injury of the midfoot?
A systematic review found there are no significant developments in the treatment of Lisfranc injuries.
A systematic review found there are no significant developments in the treatment of Lisfranc injuries.
Which imaging technique is emphasized for evaluating the Lisfranc ligament in cadaveric studies?
Which imaging technique is emphasized for evaluating the Lisfranc ligament in cadaveric studies?
The piano key test is a clinical sign for identifying subtle __________ pathology.
The piano key test is a clinical sign for identifying subtle __________ pathology.
Match the authors with their focus on Lisfranc injuries:
Match the authors with their focus on Lisfranc injuries:
Which study analyzed the tarsometatarsal joint injuries specifically in athletes?
Which study analyzed the tarsometatarsal joint injuries specifically in athletes?
CT imaging is preferred over MRI for direct visualization of soft tissues.
CT imaging is preferred over MRI for direct visualization of soft tissues.
What common sign can aid in diagnosing occult Lisfranc injuries?
What common sign can aid in diagnosing occult Lisfranc injuries?
What radiographic finding indicates a Lisfranc injury between the first and second metatarsal bases?
What radiographic finding indicates a Lisfranc injury between the first and second metatarsal bases?
Fracture fragments associated with Lisfranc injuries typically have regular margins and well-defined cortices.
Fracture fragments associated with Lisfranc injuries typically have regular margins and well-defined cortices.
What is required to restore length and aid in reduction of multiple columns in Lisfranc injuries?
What is required to restore length and aid in reduction of multiple columns in Lisfranc injuries?
On lateral weight-bearing radiographs, a finding indicative of a Lisfranc injury is reduced distance between the plantar ___ and the metatarsals.
On lateral weight-bearing radiographs, a finding indicative of a Lisfranc injury is reduced distance between the plantar ___ and the metatarsals.
Match the following findings with their related measurement indicative of a Lisfranc injury:
Match the following findings with their related measurement indicative of a Lisfranc injury:
Which of the following is a radiographic feature associated with Lisfranc injuries on oblique views?
Which of the following is a radiographic feature associated with Lisfranc injuries on oblique views?
The os intermetatarseum should always be treated as a fracture fragment in Lisfranc injuries.
The os intermetatarseum should always be treated as a fracture fragment in Lisfranc injuries.
What should be observed between the medial cuneiform and second metatarsal base to indicate a possible Lisfranc injury?
What should be observed between the medial cuneiform and second metatarsal base to indicate a possible Lisfranc injury?
Which radiographic finding indicates a Lisfranc injury on the anteroposterior view?
Which radiographic finding indicates a Lisfranc injury on the anteroposterior view?
A talometatarsal angle greater than 15 degrees is a normal finding.
A talometatarsal angle greater than 15 degrees is a normal finding.
What is a common risk associated with K-wire fixation?
What is a common risk associated with K-wire fixation?
What is the most common finding in Lisfranc injuries according to the information provided?
What is the most common finding in Lisfranc injuries according to the information provided?
The plantar cortex of C1 should project _ to the plantar cortex of M5.
The plantar cortex of C1 should project _ to the plantar cortex of M5.
Dislocations should always be reduced using open methods only.
Dislocations should always be reduced using open methods only.
Match the findings to their descriptions for Lisfranc injuries:
Match the findings to their descriptions for Lisfranc injuries:
What condition should dictate the timing of surgery for closed injuries?
What condition should dictate the timing of surgery for closed injuries?
In open injuries, impending compartment syndrome and a threatened soft tissue envelope are considered ________ emergencies.
In open injuries, impending compartment syndrome and a threatened soft tissue envelope are considered ________ emergencies.
What angle between the two black lines is considered normal?
What angle between the two black lines is considered normal?
Match the following factors with their significance in surgery timing:
Match the following factors with their significance in surgery timing:
The dorsal margins of the TMT joints should show a step-off on a weight-bearing lateral radiograph.
The dorsal margins of the TMT joints should show a step-off on a weight-bearing lateral radiograph.
What is indicated by a talometatarsal angle greater than 15 degrees?
What is indicated by a talometatarsal angle greater than 15 degrees?
What is the first column to be fixed during surgery according to the protocol?
What is the first column to be fixed during surgery according to the protocol?
Suture button devices have not been examined for their effectiveness in recent studies.
Suture button devices have not been examined for their effectiveness in recent studies.
What complication is associated with K-wire fixation in surgical procedures?
What complication is associated with K-wire fixation in surgical procedures?
What is indicated by stage I of the Lisfranc injury classification?
What is indicated by stage I of the Lisfranc injury classification?
Stage II Lisfranc injury is characterized by 1-mm to 5-mm diastasis between metatarsals.
Stage II Lisfranc injury is characterized by 1-mm to 5-mm diastasis between metatarsals.
What is a common clinical finding in high-energy Lisfranc injuries?
What is a common clinical finding in high-energy Lisfranc injuries?
Stage III Lisfranc injury results from __________ of the Lisfranc ligament complex.
Stage III Lisfranc injury results from __________ of the Lisfranc ligament complex.
Match the following stages of Lisfranc injuries with their descriptions:
Match the following stages of Lisfranc injuries with their descriptions:
What complication should be considered in the event of severe pain and swelling following a Lisfranc injury?
What complication should be considered in the event of severe pain and swelling following a Lisfranc injury?
Plain films will always show abnormal findings in Stage I Lisfranc injuries.
Plain films will always show abnormal findings in Stage I Lisfranc injuries.
Who combined clinical, radiographic, and bone scintigraphy findings into a classification system for Lisfranc injuries?
Who combined clinical, radiographic, and bone scintigraphy findings into a classification system for Lisfranc injuries?
Which component of the Lisfranc ligament is represented by thick arrows in short-axis T2-weighted FS images?
Which component of the Lisfranc ligament is represented by thick arrows in short-axis T2-weighted FS images?
The initial imaging evaluation for suspected Lisfranc injury should consist of weight-bearing radiographs.
The initial imaging evaluation for suspected Lisfranc injury should consist of weight-bearing radiographs.
What imaging technique is commonly used to assess concomitant injuries in patients with high-energy Lisfranc injuries?
What imaging technique is commonly used to assess concomitant injuries in patients with high-energy Lisfranc injuries?
The __________ component of the Lisfranc ligament is represented by graded gray bands in the anatomic diagram.
The __________ component of the Lisfranc ligament is represented by graded gray bands in the anatomic diagram.
Match the following components of Lisfranc ligaments with their descriptions:
Match the following components of Lisfranc ligaments with their descriptions:
Which finding in an imaging study suggests a stable midfoot condition?
Which finding in an imaging study suggests a stable midfoot condition?
Patients with open Lisfranc injuries require urgent débridement and stabilization.
Patients with open Lisfranc injuries require urgent débridement and stabilization.
What is assessed using axial T2-weighted FS MR images to determine the extent of Lisfranc injuries?
What is assessed using axial T2-weighted FS MR images to determine the extent of Lisfranc injuries?
Which type of trauma is associated most commonly with homolateral injuries?
Which type of trauma is associated most commonly with homolateral injuries?
Isolated injuries are the most common type of Lisfranc injury.
Isolated injuries are the most common type of Lisfranc injury.
What classification system divides Lisfranc fracture-dislocations into types A, B, and C?
What classification system divides Lisfranc fracture-dislocations into types A, B, and C?
Stage III of the Lisfranc injury indicates disruption of the ______ and ______ ligaments.
Stage III of the Lisfranc injury indicates disruption of the ______ and ______ ligaments.
Match the following Lisfranc injury types with their corresponding descriptions:
Match the following Lisfranc injury types with their corresponding descriptions:
What is a common treatment approach for Stage I Lisfranc injuries?
What is a common treatment approach for Stage I Lisfranc injuries?
Divergent injuries involve separation of metatarsals in the same direction.
Divergent injuries involve separation of metatarsals in the same direction.
What does type B injury encompass regarding metatarsal displacement?
What does type B injury encompass regarding metatarsal displacement?
What imaging technique is particularly valuable for evaluating ligament complexes due to its ability to provide thin slices for multiplanar reformatted images?
What imaging technique is particularly valuable for evaluating ligament complexes due to its ability to provide thin slices for multiplanar reformatted images?
CT is not useful for evaluating arthritis and bony deformities.
CT is not useful for evaluating arthritis and bony deformities.
What kind of injuries is MR imaging primarily important for diagnosing and managing?
What kind of injuries is MR imaging primarily important for diagnosing and managing?
The imaging sequence known as ______ can help identify marrow and soft tissue signal abnormalities.
The imaging sequence known as ______ can help identify marrow and soft tissue signal abnormalities.
Match the following imaging techniques with their primary focus:
Match the following imaging techniques with their primary focus:
What percentage more metatarsal fractures were seen at CT compared to radiography according to the study?
What percentage more metatarsal fractures were seen at CT compared to radiography according to the study?
Stress radiographs are typically performed on patients with stable Lisfranc injuries.
Stress radiographs are typically performed on patients with stable Lisfranc injuries.
What is considered abnormal in diastasis between the first and second metatarsal bases?
What is considered abnormal in diastasis between the first and second metatarsal bases?
Computed tomography is recommended when radiographic findings are _______.
Computed tomography is recommended when radiographic findings are _______.
Match the following findings with their corresponding imaging modality:
Match the following findings with their corresponding imaging modality:
What type of surgical fixation method was evaluated by Brin et al. for Lisfranc injury repair?
What type of surgical fixation method was evaluated by Brin et al. for Lisfranc injury repair?
Which of the following injuries may indicate the need for stress radiographs?
Which of the following injuries may indicate the need for stress radiographs?
The study by Kuo et al. focused on the outcomes of non-surgical treatment for Lisfranc joint injuries.
The study by Kuo et al. focused on the outcomes of non-surgical treatment for Lisfranc joint injuries.
CT imaging can demonstrate subtle fractures that are not easily identified by radiography.
CT imaging can demonstrate subtle fractures that are not easily identified by radiography.
What is the recommended approach when high clinical suspicion of Lisfranc injury exists, but radiographs show normal findings?
What is the recommended approach when high clinical suspicion of Lisfranc injury exists, but radiographs show normal findings?
Which anatomical structure is primarily associated with midfoot instability in subtle Lisfranc injuries?
Which anatomical structure is primarily associated with midfoot instability in subtle Lisfranc injuries?
A biomechanical comparison mentioned in the research focused on injuries in the __________ joint.
A biomechanical comparison mentioned in the research focused on injuries in the __________ joint.
Which imaging technique is primarily recommended for evaluating soft tissue structures?
Which imaging technique is primarily recommended for evaluating soft tissue structures?
Match the research studies with their focus area:
Match the research studies with their focus area:
Patients with stable Lisfranc injuries are often recommended to receive initial protection for the soft tissues.
Patients with stable Lisfranc injuries are often recommended to receive initial protection for the soft tissues.
What is a disadvantage of transarticular screw fixation in Lisfranc injuries?
What is a disadvantage of transarticular screw fixation in Lisfranc injuries?
Dorsal plating minimizes additional soft tissue damage compared to transarticular screw placement.
Dorsal plating minimizes additional soft tissue damage compared to transarticular screw placement.
What type of Lisfranc injury was demonstrated in the initial radiograph?
What type of Lisfranc injury was demonstrated in the initial radiograph?
Primary arthrodesis is rarely performed in ___ due to its complications.
Primary arthrodesis is rarely performed in ___ due to its complications.
Match the surgical treatment options to their advantages or characteristics:
Match the surgical treatment options to their advantages or characteristics:
What may be an alternative treatment for severely comminuted intra-articular fractures?
What may be an alternative treatment for severely comminuted intra-articular fractures?
Dorsal plating can be inserted with minimal dissection.
Dorsal plating can be inserted with minimal dissection.
What is a key function of K-wire fixation in Lisfranc injuries?
What is a key function of K-wire fixation in Lisfranc injuries?
Which components are part of the Lisfranc ligaments as seen in imaging?
Which components are part of the Lisfranc ligaments as seen in imaging?
High-energy injuries such as crush injuries are straightforward to diagnose.
High-energy injuries such as crush injuries are straightforward to diagnose.
What is the recommended management for open injuries of the Lisfranc injury?
What is the recommended management for open injuries of the Lisfranc injury?
The Lisfranc ligament is visualized as a thick band running from C1 to M2 on an axial T2-weighted FS MR image, indicated by _____ in the imaging.
The Lisfranc ligament is visualized as a thick band running from C1 to M2 on an axial T2-weighted FS MR image, indicated by _____ in the imaging.
Match the following terms with their descriptions:
Match the following terms with their descriptions:
Which of the following factors can compromise the final outcome of Lisfranc injuries?
Which of the following factors can compromise the final outcome of Lisfranc injuries?
Compartment syndrome evaluations should not be conducted in patients with high-energy injuries.
Compartment syndrome evaluations should not be conducted in patients with high-energy injuries.
What imaging technique is typically the first step in evaluating a suspected Lisfranc injury?
What imaging technique is typically the first step in evaluating a suspected Lisfranc injury?
What is a limitation of MR imaging compared to CT in the detection of fractures?
What is a limitation of MR imaging compared to CT in the detection of fractures?
What imaging technique is particularly beneficial for surgical planning in patients with complex fractures after high-energy trauma?
What imaging technique is particularly beneficial for surgical planning in patients with complex fractures after high-energy trauma?
What is the recommended imaging direction for the CT beam when assessing the injured foot?
What is the recommended imaging direction for the CT beam when assessing the injured foot?
What could be inferred if tarsometatarsal malalignment is detected on MR imaging without accompanying abnormalities?
What could be inferred if tarsometatarsal malalignment is detected on MR imaging without accompanying abnormalities?
What is an important factor to consider when diagnosing serious midfoot injuries?
What is an important factor to consider when diagnosing serious midfoot injuries?
Which imaging modality is generally superior in visualizing soft tissue structures?
Which imaging modality is generally superior in visualizing soft tissue structures?
In terms of imaging protocols, what is critical for evaluating the ligament complex in the injured foot?
In terms of imaging protocols, what is critical for evaluating the ligament complex in the injured foot?
What type of fractures may be more effectively detected using multiplanar reformatted CT data?
What type of fractures may be more effectively detected using multiplanar reformatted CT data?
What is a common characteristic of indirect injuries compared to direct injuries in the context of foot injuries?
What is a common characteristic of indirect injuries compared to direct injuries in the context of foot injuries?
Which classification describes Lisfranc fracture-dislocations based on the direction of metatarsal displacement?
Which classification describes Lisfranc fracture-dislocations based on the direction of metatarsal displacement?
What is a typical outcome associated with low-energy Lisfranc injuries?
What is a typical outcome associated with low-energy Lisfranc injuries?
Which statement accurately describes the use of existing classification systems for managing injuries?
Which statement accurately describes the use of existing classification systems for managing injuries?
What injury mechanism typically leads to the dislocation of metatarsals in Lisfranc injuries?
What injury mechanism typically leads to the dislocation of metatarsals in Lisfranc injuries?
In the classification of athletic midfoot injuries by Nunley and Vertullo, which factor is primarily considered?
In the classification of athletic midfoot injuries by Nunley and Vertullo, which factor is primarily considered?
Which type of ligament is classified as a plantar ligament in the context of Lisfranc injuries?
Which type of ligament is classified as a plantar ligament in the context of Lisfranc injuries?
What challenge is most commonly associated with diagnosing low-energy Lisfranc injuries?
What challenge is most commonly associated with diagnosing low-energy Lisfranc injuries?
What is the primary treatment for patients with Nunley and Vertullo stage II injuries?
What is the primary treatment for patients with Nunley and Vertullo stage II injuries?
In the management of Lisfranc injuries, what is the recommended imaging modality for further assessment when initial radiographs show normal findings but there is still a high clinical suspicion?
In the management of Lisfranc injuries, what is the recommended imaging modality for further assessment when initial radiographs show normal findings but there is still a high clinical suspicion?
What is the recommended treatment for stable Lisfranc injuries that are nondisplaced?
What is the recommended treatment for stable Lisfranc injuries that are nondisplaced?
What is often crucial to repeat two weeks after the initial presentation of a Lisfranc injury?
What is often crucial to repeat two weeks after the initial presentation of a Lisfranc injury?
For which of the following situations is nonoperative treatment likely indicated?
For which of the following situations is nonoperative treatment likely indicated?
Which stage of Lisfranc injury does not require surgical intervention and can be treated conservatively?
Which stage of Lisfranc injury does not require surgical intervention and can be treated conservatively?
What imaging approach is recommended for evaluating subtle malalignment in weight-bearing radiographs of the Lisfranc joint?
What imaging approach is recommended for evaluating subtle malalignment in weight-bearing radiographs of the Lisfranc joint?
What might indicate a need for surgical stabilization in cases of Lisfranc injury despite initial imaging showing no significant findings?
What might indicate a need for surgical stabilization in cases of Lisfranc injury despite initial imaging showing no significant findings?
Which imaging technique offers the advantage of optimized contrasts when evaluating the Lisfranc joint?
Which imaging technique offers the advantage of optimized contrasts when evaluating the Lisfranc joint?
What is the primary focus of the research conducted by Raikin et al. regarding Lisfranc injuries?
What is the primary focus of the research conducted by Raikin et al. regarding Lisfranc injuries?
In Kuo et al.'s study, what surgical outcome was evaluated following open reduction and internal fixation of Lisfranc joint injuries?
In Kuo et al.'s study, what surgical outcome was evaluated following open reduction and internal fixation of Lisfranc joint injuries?
What technique was specifically used in a biomechanical analysis of Lisfranc injury fixation devices in the study by Pelt et al.?
What technique was specifically used in a biomechanical analysis of Lisfranc injury fixation devices in the study by Pelt et al.?
Which research specifically discusses a biomechanical comparison of methods for treating ligamentous Lisfranc injuries?
Which research specifically discusses a biomechanical comparison of methods for treating ligamentous Lisfranc injuries?
What is the relevance of the TightRope device in the context of Lisfranc injury repair as mentioned by Brin et al.?
What is the relevance of the TightRope device in the context of Lisfranc injury repair as mentioned by Brin et al.?
Which part of the Lisfranc joint injuries does the study by Ly et al. emphasize primarily?
Which part of the Lisfranc joint injuries does the study by Ly et al. emphasize primarily?
What aspect of MRI utilization is evaluated in the study by Ulbrich et al. regarding the Lisfranc ligament?
What aspect of MRI utilization is evaluated in the study by Ulbrich et al. regarding the Lisfranc ligament?
What is a common feature associated with complete tears of the ligament in Lisfranc injuries?
What is a common feature associated with complete tears of the ligament in Lisfranc injuries?
What challenge arises in diagnosing Lisfranc injuries during the chronic phase?
What challenge arises in diagnosing Lisfranc injuries during the chronic phase?
Which ligament was noted to be the most commonly injured in American football players with suspected Lisfranc injuries?
Which ligament was noted to be the most commonly injured in American football players with suspected Lisfranc injuries?
What type of imaging is especially useful for assessing associated injuries with Lisfranc injuries?
What type of imaging is especially useful for assessing associated injuries with Lisfranc injuries?
In assessing Lisfranc injuries, which other soft tissue injuries might be encountered?
In assessing Lisfranc injuries, which other soft tissue injuries might be encountered?
What is a noted imaging finding related to the quality of the injured ligament in the chronic phase?
What is a noted imaging finding related to the quality of the injured ligament in the chronic phase?
What type of injury is primarily assessed when examining for diastasis at the Lisfranc joint?
What type of injury is primarily assessed when examining for diastasis at the Lisfranc joint?
What type of dislocation is typically noted in Lisfranc injuries involving the metatarsals?
What type of dislocation is typically noted in Lisfranc injuries involving the metatarsals?
Which factor is associated with the anatomical structure of the Lisfranc joint complex?
Which factor is associated with the anatomical structure of the Lisfranc joint complex?
What imaging finding is frequently analyzed for diagnosing Lisfranc joint injuries?
What imaging finding is frequently analyzed for diagnosing Lisfranc joint injuries?
In the context of Lisfranc injuries, what does the term 'diastasis' refer to?
In the context of Lisfranc injuries, what does the term 'diastasis' refer to?
What is a common complication associated with untreated Lisfranc fractures?
What is a common complication associated with untreated Lisfranc fractures?
Which publication investigates the outcomes of surgical approaches for Lisfranc injuries?
Which publication investigates the outcomes of surgical approaches for Lisfranc injuries?
Which imaging technique is noted for its effectiveness in visualizing complications of Lisfranc injuries?
Which imaging technique is noted for its effectiveness in visualizing complications of Lisfranc injuries?
What anatomical feature of the Lisfranc joint makes dating ligamentous injuries challenging?
What anatomical feature of the Lisfranc joint makes dating ligamentous injuries challenging?
Which clinical sign is commonly used to assess subtle Lisfranc injuries in athletes?
Which clinical sign is commonly used to assess subtle Lisfranc injuries in athletes?
Flashcards
Lisfranc Joint Complex
Lisfranc Joint Complex
A group of ligaments that connect the tarsals and metatarsals, contributing to the stability of the midfoot.
Dorsal Ligaments
Dorsal Ligaments
Ligaments located on the top of the foot, responsible for stabilizing the Lisfranc joint.
Plantar Ligaments
Plantar Ligaments
Ligaments located on the bottom of the foot, contributing to the stability of the midfoot.
Plantar Lisfranc Ligament
Plantar Lisfranc Ligament
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Lisfranc Ligament
Lisfranc Ligament
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Intertarsal Ligaments
Intertarsal Ligaments
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Intermetatarsal Ligaments
Intermetatarsal Ligaments
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Interosseous Ligaments
Interosseous Ligaments
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CT vs MR for fracture detection
CT vs MR for fracture detection
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CT for high-energy midfoot injuries
CT for high-energy midfoot injuries
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MR for soft tissue visualization
MR for soft tissue visualization
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MR limitations for avulsion fractures
MR limitations for avulsion fractures
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Tarsometatarsal malalignment on MR
Tarsometatarsal malalignment on MR
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Optimal CT beam orientation
Optimal CT beam orientation
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T1-weighted sequences on MR
T1-weighted sequences on MR
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MR imaging parameters
MR imaging parameters
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What is a Lisfranc injury?
What is a Lisfranc injury?
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What are WB radiographs?
What are WB radiographs?
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What is MR imaging?
What is MR imaging?
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What are stress radiographs under anesthesia?
What are stress radiographs under anesthesia?
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What is ORIF?
What is ORIF?
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What is nonoperative treatment in Lisfranc injuries?
What is nonoperative treatment in Lisfranc injuries?
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What is a controlled ankle motion walking boot?
What is a controlled ankle motion walking boot?
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What is the Nunley and Vertullo classification?
What is the Nunley and Vertullo classification?
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What is the Lisfranc joint complex?
What is the Lisfranc joint complex?
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Why is MR imaging important for Lisfranc injuries?
Why is MR imaging important for Lisfranc injuries?
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What makes CT imaging ideal for Lisfranc fracture detection?
What makes CT imaging ideal for Lisfranc fracture detection?
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What is ORIF treatment for Lisfranc injuries?
What is ORIF treatment for Lisfranc injuries?
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Describe non-operative treatment for Lisfranc injuries.
Describe non-operative treatment for Lisfranc injuries.
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What is nonoperative treatment for Lisfranc injuries?
What is nonoperative treatment for Lisfranc injuries?
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What is the Piano Key test?
What is the Piano Key test?
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Why are Lisfranc injuries important to understand?
Why are Lisfranc injuries important to understand?
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How are Lisfranc injuries diagnosed?
How are Lisfranc injuries diagnosed?
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How are Lisfranc injuries treated?
How are Lisfranc injuries treated?
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When is a CT scan especially important?
When is a CT scan especially important?
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When is an MRI more helpful?
When is an MRI more helpful?
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What are the limitations of MRIs in Lisfranc injuries?
What are the limitations of MRIs in Lisfranc injuries?
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Why is tarsometatarsal malalignment on MRI important?
Why is tarsometatarsal malalignment on MRI important?
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Classifying Lisfranc Injuries
Classifying Lisfranc Injuries
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Direct Lisfranc Injuries
Direct Lisfranc Injuries
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Indirect Lisfranc Injuries
Indirect Lisfranc Injuries
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Low-Energy Lisfranc Injuries
Low-Energy Lisfranc Injuries
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Quenu and Kuss Classification
Quenu and Kuss Classification
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Nunley and Vertullo Classification
Nunley and Vertullo Classification
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CT Imaging for High-Energy Midfoot Injuries
CT Imaging for High-Energy Midfoot Injuries
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MR Imaging for Soft Tissue Visualization
MR Imaging for Soft Tissue Visualization
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What are WB (weight-bearing) radiographs?
What are WB (weight-bearing) radiographs?
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What is the talometatarsal angle?
What is the talometatarsal angle?
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What is a dorsal subluxation of the metatarsals?
What is a dorsal subluxation of the metatarsals?
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What is lateral step-off at the medial margin of the 2nd TMT joint?
What is lateral step-off at the medial margin of the 2nd TMT joint?
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What is ORIF (Open Reduction Internal Fixation)?
What is ORIF (Open Reduction Internal Fixation)?
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CT for Fracture Detection
CT for Fracture Detection
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MR for Soft Tissue
MR for Soft Tissue
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CT for High-Energy Injuries
CT for High-Energy Injuries
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MR Limitations with Avulsion Fractures
MR Limitations with Avulsion Fractures
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Why is CT imaging superior in Lisfranc injuries?
Why is CT imaging superior in Lisfranc injuries?
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What is the "Fleck" sign?
What is the "Fleck" sign?
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What is a diastasis in a Lisfranc injury?
What is a diastasis in a Lisfranc injury?
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What are stress radiographs and how are they used for Lisfranc injuries?
What are stress radiographs and how are they used for Lisfranc injuries?
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When is CT imaging especially recommended for Lisfranc injuries?
When is CT imaging especially recommended for Lisfranc injuries?
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What is a limitation of MRI in Lisfranc injuries?
What is a limitation of MRI in Lisfranc injuries?
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How does CT compare to radiography in detecting fractures?
How does CT compare to radiography in detecting fractures?
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Why is MR imaging important in evaluating Lisfranc injuries?
Why is MR imaging important in evaluating Lisfranc injuries?
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WB exercises
WB exercises
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CT scan for complex Lisfranc fractures
CT scan for complex Lisfranc fractures
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MR imaging for soft tissue in Lisfranc injuries
MR imaging for soft tissue in Lisfranc injuries
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Closed reduction for Lisfranc dislocation
Closed reduction for Lisfranc dislocation
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ORIF for unstable Lisfranc injuries
ORIF for unstable Lisfranc injuries
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Non-operative management of stable Lisfranc injuries
Non-operative management of stable Lisfranc injuries
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Anatomic reduction for Lisfranc recovery
Anatomic reduction for Lisfranc recovery
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Open reduction for achieving anatomic reduction
Open reduction for achieving anatomic reduction
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What are weight-bearing (WB) radiographs?
What are weight-bearing (WB) radiographs?
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Why is CT imaging crucial for complex Lisfranc fractures?
Why is CT imaging crucial for complex Lisfranc fractures?
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What is the advantage of MR imaging over CT when assessing Lisfranc injuries?
What is the advantage of MR imaging over CT when assessing Lisfranc injuries?
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When is ORIF used for Lisfranc injuries?
When is ORIF used for Lisfranc injuries?
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Dorsal subluxation of the metatarsals
Dorsal subluxation of the metatarsals
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Lateral step-off at the medial margin of the 2nd TMT joint
Lateral step-off at the medial margin of the 2nd TMT joint
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Talometatarsal Angle
Talometatarsal Angle
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What are WB radiographs and why are they used?
What are WB radiographs and why are they used?
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What is ORIF for Lisfranc injuries?
What is ORIF for Lisfranc injuries?
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What is ORIF (Open Reduction Internal Fixation) for Lisfranc injuries?
What is ORIF (Open Reduction Internal Fixation) for Lisfranc injuries?
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Describe non-operative treatment for stable Lisfranc injuries.
Describe non-operative treatment for stable Lisfranc injuries.
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Why is anatomic reduction crucial for Lisfranc recovery?
Why is anatomic reduction crucial for Lisfranc recovery?
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How is anatomic reduction best achieved in Lisfranc injuries?
How is anatomic reduction best achieved in Lisfranc injuries?
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What is the Lisfranc joint?
What is the Lisfranc joint?
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Explain the three columns of the Lisfranc joint.
Explain the three columns of the Lisfranc joint.
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What's the biomechanical significance of the Lisfranc joint?
What's the biomechanical significance of the Lisfranc joint?
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Describe the classification of Lisfranc injuries.
Describe the classification of Lisfranc injuries.
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Why are weight-bearing radiographs important for Lisfranc injuries?
Why are weight-bearing radiographs important for Lisfranc injuries?
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Why is anatomic reduction critical in the treatment of Lisfranc injuries?
Why is anatomic reduction critical in the treatment of Lisfranc injuries?
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What is the Plantar Lisfranc Ligament?
What is the Plantar Lisfranc Ligament?
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How are Lisfranc injuries caused?
How are Lisfranc injuries caused?
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Why is CT imaging recommended for high-energy Lisfranc injuries?
Why is CT imaging recommended for high-energy Lisfranc injuries?
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Why is MRI imaging important for evaluating Lisfranc injuries?
Why is MRI imaging important for evaluating Lisfranc injuries?
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What is a CAM boot used for in Lisfranc injuries?
What is a CAM boot used for in Lisfranc injuries?
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Why are WB (weight-bearing) radiographs used?
Why are WB (weight-bearing) radiographs used?
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Lisfranc Injury
Lisfranc Injury
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Weight-bearing (WB) Radiographs
Weight-bearing (WB) Radiographs
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ORIF (Open Reduction Internal Fixation)
ORIF (Open Reduction Internal Fixation)
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What is the Quenu and Kuss Classification?
What is the Quenu and Kuss Classification?
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What is Non-Operative Management of Stable Lisfranc Injuries?
What is Non-Operative Management of Stable Lisfranc Injuries?
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Stress Radiographs
Stress Radiographs
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CAM Boot
CAM Boot
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ORIF (Open Reduction Internal Fixation) for Lisfranc Injuries
ORIF (Open Reduction Internal Fixation) for Lisfranc Injuries
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What is closed reduction?
What is closed reduction?
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What is ORIF for unstable Lisfranc injuries?
What is ORIF for unstable Lisfranc injuries?
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What are the columns of the Lisfranc joint?
What are the columns of the Lisfranc joint?
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Describe the three columns of the Lisfranc joint.
Describe the three columns of the Lisfranc joint.
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Direct Lisfranc Injury
Direct Lisfranc Injury
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Indirect Lisfranc Injury
Indirect Lisfranc Injury
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Anatomic Reduction
Anatomic Reduction
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Why is CT imaging superior for Lisfranc injuries?
Why is CT imaging superior for Lisfranc injuries?
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What are Stress Radiographs?
What are Stress Radiographs?
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Causes of Lisfranc Injuries
Causes of Lisfranc Injuries
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Columns of the Lisfranc Joint
Columns of the Lisfranc Joint
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Importance of Weight-Bearing Radiographs for Lisfranc Injuries
Importance of Weight-Bearing Radiographs for Lisfranc Injuries
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Importance of Anatomic Reduction in Lisfranc Treatment
Importance of Anatomic Reduction in Lisfranc Treatment
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CT Scan for High-Energy Lisfranc Injuries
CT Scan for High-Energy Lisfranc Injuries
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MRI for Evaluating Lisfranc Injuries
MRI for Evaluating Lisfranc Injuries
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Controlled Ankle Motion (CAM) Boot
Controlled Ankle Motion (CAM) Boot
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Open Reduction
Open Reduction
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What are the three columns of the Lisfranc joint?
What are the three columns of the Lisfranc joint?
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How are Lisfranc injuries classified?
How are Lisfranc injuries classified?
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Why is anatomic reduction critical in treating Lisfranc injuries?
Why is anatomic reduction critical in treating Lisfranc injuries?
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Nonoperative Treatment of Lisfranc Injuries
Nonoperative Treatment of Lisfranc Injuries
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Anatomic Reduction in Lisfranc Injuries
Anatomic Reduction in Lisfranc Injuries
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Diastasis in Lisfranc Injury
Diastasis in Lisfranc Injury
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Study Notes
Lisfranc Injury Current Concepts
- Lisfranc injury involves the tarsometatarsal (TMT) joints of the midfoot, ranging from sprains to fractures to dislocations.
- Prompt diagnosis and appropriate treatment preventing osteoarthritis and deformity are key.
- Radiographic evaluation requires a thorough assessment of subtle fractures and misalignment in all views.
- Computed tomography (CT) and magnetic resonance imaging (MRI) are crucial for diagnosing low-energy injuries.
Introduction
- Lisfranc injuries are uncommon, accounting for ~0.2% of all fractures.
- They frequently coexist with other tarsal or metatarsal fractures.
- US incidence is ~1 per 55,000 annually, potentially underestimated, with ~1/3 missed initially.
- High-energy injuries are typically secondary to traumatic events (e.g., motor vehicle accidents, falls) while low-energy injuries often result from athletic trauma or missteps.
- Motor vehicle accidents are the most common mechanism (~40-45%), followed by low-energy mechanisms (~30%).
- Lisfranc injuries account for >15% of athletic injuries, and are increasing in prevalence.
- Injuries occur most frequently in the third decade of life.
- Males are more prone to Lisfranc injuries due to greater participation in high-speed activities.
- Lisfranc injuries can occur as part of neuropathic arthropathy.
- Lisfranc injuries occur in 4% of football players and 29.2% of offensive linemen per year.
- The "bunk bed" fracture is the pediatric equivalent of the TMT fracture-dislocation in adults.
Anatomy
- The midfoot consists of 5 bones (3 cuneiforms, cuboid, navicular).
- The Lisfranc joint encompasses the articulations between the cuneiforms and cuboid, and the 5 metatarsals.
- The second metatarsal plays a keystone role, maintaining coronal plane stability.
- The TMT joints transition from medial to lateral in the transverse plane.
- The anatomical configuration is critical for mobility during weight-bearing activities.
- The midfoot is categorized into three columns (medial, middle, lateral), each with variable degrees of mobility. The middle column is the most rigid.
Ligaments
- The Lisfranc joint complex comprises the TMT articular surfaces, intermetatarsal and anterior intertarsal surfaces and reinforcing ligaments.
- Dorsal, plantar, and interosseous ligaments are crucial structures for stability. The dorsal ligaments are generally more vulnerable than the plantar ones.
- The Lisfranc ligament (medial longitudinal ligament) is the largest TMT ligament.
- The plantar ligaments are generally stronger than the dorsal ligaments.
Mechanism of Injury
- Lisfranc injuries can result from direct or indirect forces.
- High-energy direct injuries are typically associated with motor vehicle accidents or falls. These can lead to plantar or dorsal dislocation of metatarsals, and often coincide with other tarsal or metatarsal fractures.
- Low-energy indirect injuries, often seen in athletics, are due to excessive force applied during plantar flexion resulting from a fall, misstep, or during athletic activities as demonstrated during certain sports (e.g., football, gymnastic).
- Indirect injuries can result from falls, sports activities, missteps, or even a misstep, or while riding a horse (during a fall).
Classifications
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Several classification systems exist, with the Myerson classification being a commonly used approach. Myerson categorizes injuries into types A, B, and C, based on degree of displacement:
- Type A: Total incongruity
- Type B: Partial incongruity (B1- medial, B2-lateral)
- Type C: Divergent displacement (C1-partial, C2-total)
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The Quenu and Kuss classification system, while simpler, is also frequently used for practical purposes. This system classifies Lisfranc injuries by the direction of metatarsal displacement (homolateral, isolated, or divergent).
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The Nunley and Vertullo classification system is directed towards athletic injuries, focusing on clinical, radiographic and bone scan findings. This system classifies the severity into Stages I, II, and III, according to the presence of diastasis and arch height loss.
Diagnosis
- Clinical findings include variable swelling and pain, particularly on palpation or manipulation of the TMT joints.
- The "piano key test" is an important diagnostic maneuver.
- Radiographic assessment requires anteroposterior, oblique, and lateral views (NWB and WB). Comparison views with the uninjured foot are crucial.
- Computed tomography (CT), especially with multiplanar capabilities, offers added advantages for visualizing subtle fracture patterns and malalignment, and allows for visualization of unobscured osseous anatomy.
- Magnetic resonance imaging (MRI) is helpful in diagnosing low-energy injuries, depicting marrow edema, ligament tears, and soft tissue abnormalities not clearly visible in radiographic views.
Management
- Management strategies are tailored based on injury severity and the presence of fractures or dislocations.
- Stable injuries may be managed conservatively (e.g., immobilization).
- Unstable injuries necessitate surgical intervention (ORIF), often with transarticular screws.
- The timing of surgery depends on several factors including wound conditions and the status of surrounding tissues. Additional factors to consider are patient mobility needs and activities.
- Goals of treatment include restoring the precise anatomical relationship and achieving a painless, stable foot. The key is to determine if the injury is stable or unstable (involving bone displacement or dislocation) to inform whether non-surgical or surgical treatment is appropriate.
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Description
Test your knowledge on the tarsometatarsal joint complex, including common imaging modalities and treatment options for injuries. This quiz covers anatomy, diagnosis, and the implications of tarsometatarsal injuries, providing insight into sports-related foot and ankle issues.
