BOFAS News & Events

This pages lists all the latest news and upcoming events.

 

To access 'Foot Print' (the BOFAS Bulletin) please click here (members only)

 

Latest News

Togay Koç
/ Categories: Abstracts, 2018, Podium

The natural history of undisplaced Lisfranc-type injuries initially treated conservatively

P. Chen, N. Ng, S.P. Mackenzie, J.A. Nicholson, A.K. Amin

Background: Undisplaced Lisfranc-type injuries are subtle but potentially unstable fracture-dislocations with little known about the natural history. These injuries are often initially managed conservatively due to lack of initial displacement and uncertainty regarding subsequent instability at the tarsometatarsal joints (TMTJ). The aim of this study was to determine the secondary displacement rate and the need for delayed operative intervention in undisplaced Lisfranc injuries that were managed conservatively at initial presentation.

Methods: Over a 6-year period (2011 to 2017), we identified 24 consecutive patients presenting to a university teaching hospital with a diagnosis of an undisplaced Lisfranc-type injury that was initially managed conservatively. Pre-operative radiographs were reviewed to confirm the undisplaced nature of the injury (defined as a diastasis< 2mm at the second TMTJ). The presence of a 'fleck' sign (small bony avulsion of the second metatarsal) was also noted. Electronic patient records and sequential imaging (plain radiographs/CT/MRI) were scrutinized for demographics, mechanism of injury and eventual outcome.

Results: The mean age of the patients at the time of injury was 42 years (19 Female). 96% (23/24) were low energy injuries and 88% (21/24) had a positive 'fleck sign'. The secondary displacement rate in this group of patients was 62.5% (15/24) over a median interval of 14 days (range 0 to 482 days). 12 patients underwent open reduction internal fixation after a median interval of 29 days (range 1 to 294 days) from their initial injury. One patient required TMTJ fusion at 19 months and two patients were managed non-operatively. The injury remained undisplaced in 37.5% patients (9/24) with only one patient requiring subsequent TMTJ fusion at 5 months.

Conclusion: Undisplaced Lisfranc injuries have a high rate of secondary displacement and warrant close follow-up. Early primary stabilisation of undisplaced Lisfranc injuries should be considered to prevent unnecessary delays in surgical treatment.

 

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Tags: TraumaLisfranc

 

BOFAS Hosted Events

This courses is designed to develop and extend the knowledge and skills of training foot and ankle surgeons. Techniques of arthroscopic surgery of the joints, ligaments and tendons of the ankle and foot will be presented and demonstrated. Basic Skills covers the more common procedures which a foot and ankle surgeon would be likely to need. Delegates will be given ample time to develop their skills in each of the areas listed below using cadaver limbs. Questions and case presentations will be encouraged with an expert and interactive faculty.

Anterior ankle
Posterior ankle 
Haglund’s surgery
Sub-talar joint
Tendoscopy
Arthroscopic Ankle fusion
1st MTP joint

 

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This courses is designed to develop and extend the knowledge and skills of established foot and ankle surgeons. Techniques of arthroscopic surgery of the joints, ligaments and tendons of the ankle and foot will be presented and demonstrated. Advanced Skills covers some more advanced and emerging techniques. Delegates will be given ample time to develop their skills in each of the areas listed below using cadaver limbs. Questions and case presentations will be encouraged with an expert and interactive faculty.

1st MTP joint
Arthroscopic lateral and medial ligament repair FHL transfer
Peroneal groove and Tibialis posterior
Tarsal coalition excision
Sub-talar fusion
Chopart joint fusion

 

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BOFAS Principles Course Taunton

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These courses are aimed at Higher Surgical Trainees / ST3 onwards and are designed to teach the core of Foot and Ankle surgery in an informal and interactive environment. The emphasis is on clinical examination cases, discussion groups and typical day-to-day clinic scenarios. Although not an exam preparation course, content is taught to the standard expected in the FRCS(Tr & Orth) exam; that of a day-one non-specialist orthopaedic consultant. Applications will open on 1st September 2023.

Venue - Taunton (TBC)

 

 

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BOFAS Supported Events

Other Upcoming Events / Courses