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01-08-2008 | Nascholing

Luxaties en luxatiefracturen in gewricht van Lisfranc: tarsometatarsale letsels

Auteurs: J. S. Harbers, K. W. Wendt, H. J. ten Duis

Gepubliceerd in: Nederlands Tijdschrift voor Traumachirurgie | Uitgave 4/2008

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Samenvatting

Luxaties en luxatiefracturen van het tarsometatarsale (lisfranc)gewricht komen niet frequent voor, maar kunnen bij een gemiste diagnose of inadequate behandeling leiden tot een aanzienlijke morbiditeit, zoals symptomatische tarsometatarsale artrose en standsafwijkingen. Bij voetletsels, en in het bijzonder de hoogenergetische, is een hoge suspectie voor tarsometatarsale letsels aangewezen. Aanvullende röntgendiagnostiek dient laagdrempelig te worden verricht. Bij luxaties en luxatiefracturen van het lisfrancgewricht is een ct-scan noodzakelijk. Doel van de behandeling is een stabiele, pijnloze, plantigrade voet.
Een anatomische reductie (en dientengevolge gewrichtscongruentie) geeft een beter klinisch resultaat en vermindert de kans op het ontwikkelen van posttraumatische artrose. Anatomische reductie wordt het best bereikt door een open repositie en stabiele interne fixatie van het tarsometatarsale gewrichtsoppervlak, met als adagium ‘mediaal stabiliteit, lateraal mobiliteit’. Kennis van de anatomie van de middenvoet, het wekedelenmanagement en het tweede tarsometatarsale gewricht staan bij de behandeling centraal.
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Metagegevens
Titel
Luxaties en luxatiefracturen in gewricht van Lisfranc: tarsometatarsale letsels
Auteurs
J. S. Harbers
K. W. Wendt
H. J. ten Duis
Publicatiedatum
01-08-2008
Uitgeverij
Bohn Stafleu van Loghum
Gepubliceerd in
Nederlands Tijdschrift voor Traumachirurgie / Uitgave 4/2008
Print ISSN: 2214-8736
Elektronisch ISSN: 2214-8744
DOI
https://doi.org/10.1007/BF03077216