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Online ISSN 1827-1707
97° CONGRESS OF THE PIEDMONTESE-LIGURIAN-LOMBARD SOCIETY OF ORTHOPEDICS AND TRAUMATOLOGY (SPLLOT) - I (Alba, September 22-23, 2000)
Pasquali M., Lancione V., Fassola I.
The traumatic pathology of tarso-metatarsal joint (Lisfranc's joint) isn't so usual and is about 0.2% of all fractures. The stability of Lisfranc's joint is due to osseous, ligamentous and muscular factors. The particular anatomic distribution of ligamentous structures in this joint justifies the higher incidence of injuries on its dorsal side, which appears to be less ''protected'' than the plantar side, where many muscles and tendons add their stabilising action. Our revision of the most important classifications shows the great limit of the failure of relation between the causal mechanism, the anatomic aspect, the radiographic aspect and the prognostic value. An additional problem is the high incidence of misdiagnosis (about 20%) due to the frequent association with other major injuries which often mask them. This happens in high energy traumas; in this case it's required, for an appropriate diagnosis and prompt treatment, that the simple ''clinical suspicion'' leads to an adequate instrumental diagnosis. To solve this problem, conventional radiology, which often represents the first and only approach, when used without comparatives and additional views, appears to be less detailed than CT and MR.