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Dr. Kinast lectured from 27.-28.06.2014 in 5th International Symposium of Surgical and Biological Treatments in Orthopaedics, Sports Medicine and Distal Extremity Pathologies im CNIT in Paris: Foot and Ankle II (Live surgical, scientific discussions, meet the experts): “Trauma of the Lower Extremity”: Osteoarthritis of the Lisfranc Joints Associated foot deformities with atraumatic Lisfranc osteoarthritis pes planovalgus hallux valgus or skew foot deformities hallux valgus with pes planovalgus pes cavus in-situ without deformities Secondary flatfoot due to short metatarsus and secondary Lisfranc osteoarthitis Lisfranc correction arthrodesis TKA total knee arthroplasty Atraumatic Lisfranc osteoarthritis with hypermobile metatarsus primus varus MRI helps to visualise the extent of arthritic changes Arthrex Mini Joint Distractor Distraction of the Lisfranc joint Bonesaving preparation for the arthrodesis Lapidus Plate; Quickfix Can. Screws 4.0, 3.0, 2.4 mm; Double-Compression Plate Double Compression Plate bonegrafting from calcaneus Double Compression Plates Double compression due to oblong hole manual bending of middle portion 3.5 mm locking and non-locking screws 2, 3 and 4 holes 20, 25 und 30 mm lengths Lisfranc Plates 3 locking holes, 1 compression hole Compression along the lisfranc ligament CT allow visualization of lisfranc joint during healing process 3 Sizes: Small, Medium, Large QuickFix Cannulated Screws + Lisfranc Plate Lapidus Plate + Compression Staples Flatfoot with peritalar subluxation and Lisfranc atraumatic subluxation Calcaneus Step-Plate; H-Plate Plate (Evans); Headless Compression Screw Lisfranc Arthrodesis Rehabilitation 2 weeks valved cast 4 - 6 weeks closed cast Week 7 – 10 increased weight baring CT scan week 10 - 12 ( difficult to read ) Week 11-12 full weight bearing Conclusion Identify the underlying deformity of the foot in atraumatic Lisfranc osteoarthritis pes planovalgus with peritalar subluxation / Lisfranc subluxation hallux valgus or skew foot deformities hallux valgus with pes planovalgus pes cavus in-situ without deformities postraumatic osteoarthritis rheumatoid arthritis neuro-osteo-arthropathy Arthrex Implants Lapidus Plate Lisfranc Plate Arthrex Headless Compression Screws Quickfix Cannulated Screws 2.4, 3.0, 4.0mm Compression Staples Double Compression Plate Calcaneus StepPlate H-Plate (Evans) contact: Dr. med. Christian Kinast ORTHOPEDIC CENTER ARABELLAPARK MUNICH Englschalkinger Str. 12 / 3rd floor D-81925 Munich T: +49 89 / 9 99 09 78 – 0 F: +49 89 / 9 99 09 78 – 77 E: info@oza-m.de I: www.oza-m.de facebook: www.facebook.com/oza.muenchen
Citation preview
Osteoarthritis of the Lisfranc Joint
Christian KinastMunic Germany
Associated foot deformities with atraumatic Lisfranc osteoarthritis
pes planovalgus hallux valgus or skew foot deformities hallux valgus with pes planovalgus pes cavus in-situ without deformities
Foot Ankle Int 2007 28: 482Hong Geun Jung, Mark S. Myerson and Lew C. SchonSpectrum of Operative Treatments and Clinical Outcomes for Atraumatic Osteoarthritis of the Tarsometatarsal Joints
Secondary flatfoot due to short metatarsus and secondary Lisfranc osteoarthitis
ST. I
Lisfranc correction arthrodesis TKA
59 y fem playing badminton again
ST.I
Atraumatic Lisfranc osteoarthritiswith hypermobile metatarsus primus varus
MRI helps to visualise the extent of arthritic changes
Arthrex Mini Joint Distractor
• Distraction of the Lisfranc joint • Bonesaving preparation for the arthrodesis
Lapidus Plate; Quickfix Can. Screws 4.0, 3.0, 2.4 mm; Double-Compression Plate
bonegraftingfrom calcaneus
Double Compression Plate
Double Compression Plates
• Double compression due to - oblong hole- manual bending of middle portion
• 3.5 mm locking and non-locking screws• 2, 3 and 4 holes• 20, 25 und 30 mm lengths
Lisfranc Plates
• 3 locking holes, 1 compression hole• Compression along the lisfranc lig.• Allow visualization of lisfranc joint
during healing process • 3 Sizes: Small, Medium, Large
QuickFix Cannulated Screws + Lisfranc Plate
Hö.A
Lapidus Plate + Compression Staples
CT control
Ha.E
Flatfoot with peritalar subluxation and Lisfranc atraumatic subluxationCalcaneus StepPlate; H-Plate Plate (Evans); Headless Compression Screw
Lisfranc Arthrodesis Rehabilitation
2 weeks valved cast 4 - 6 weeks closed cast Week 7 – 10 increased weight baring CT scan week 10 - 12 ( difficult to read ) Week 11-12 full weight bearing
Conclusion
Identify the underlying deformity of the foot in atraumatic Lisfranc osteoarthritis
pes planovalgus with peritalar subluxation / Lisfranc subluxation hallux valgus or skew foot deformities hallux valgus with pes planovalgus pes cavus in-situ without deformities postraumatic osteoarthritis rheumatoid arthritis neuro-osteo-arthropathy
Arthrex Implants
Lapidus Plate Lisfranc Plate Arthrex Headless Compression Screws Quickfix Cannulated Screws 2.4, 3.0, 4.0mm Compression Staples Double Compression Plate Calcaneus StepPlate H-Plate (Evans)
Thank you for your attention.
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