Date: Mon, 16 Sep 2002 15:03:04 +0300

Subject: Foot Injury

Dear colleagues!

35-year-old male patient was injured falling from height. Among different injuries he acquired a complex foot trauma (fractures of metatarsus and tarsus bones, dislocations of Lisfranc and Chopart joints). Closed reposition and fixation with plaster were carried out.

What is the further treatment?

Best wishes,

dr. Anton Vladzymyrskyy
R&D Institute of Traumatology and Orthopedy
Donetsk, Ukraine
WWW: http://www.telemed.org.ua

Date: Mon, 16 Sep 2002 11:33:51 -0700

From: Bruce Sangeorzan

these injuries are very difficult and frustrating. the 2 best options are to place a medial and lateral fixator or a medial and lateral bridge plate that acts as an internal fixator. it bridges from the talus to the first metatarsal on the medial side and the calcaneus to the 4th metatarsal on the lateral side.

Bruce Sangeorzan, MD
Professor of Orthopedic Surgery and Sports Medicine
University of Washington
Harborview Medical Center

Date: Tue, 17 Sep 2002 12:13:47 -0600

From: Thomas A. DeCoster

I agree with Dr. Sangeorzan. Another approach commonly attempted is some sort of close or semi-open K wire fixation but those results are not necessarily better than nonoperative treatment. The external fixation or internal fixator stabilization with reduction seems to offer the best hope. TDeCoster