This Article Full Text Full Text (PDF) Letters to the Editor: Submit a response Letters to the Editor: View responses Alert me when this article is cited Alert me when Letters to the Editor are posted Alert me if a correction is posted Services E-mail this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to My File Cabinet Download to citation manager Rights and Permissions Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Panchbhavi, V. K. Articles by Andersen, C. R. Search for Related Content PubMed PubMed Citation Articles by Panchbhavi, V. K. Articles by Andersen, C. R. Related Collections Foot/Ankle Social Bookmarking                   What's this?

Screw Fixation Compared with Suture-Button Fixation of Isolated Lisfranc Ligament Injuries

¹ The University of Texas Medical Branch, 301 University Boulevard, Galveston, TX 77555-0165. E-mail address for V.K. Panchbhavi: vkpanchb{at}utmb.edu. E-mail address for S. Vallurupalli: santaramv{at}gmail.com. E-mail address for J. Yang: jyang{at}utmb.edu. E-mail address for C.R. Andersen: clanders{at}utmb.edu

Investigation performed at the Department of Orthopaedic Surgery and Rehabilitation, The University of Texas Medical Branch, Galveston, Texas

Disclosure: In support of their research for or preparation of this work, one or more of the authors received, in any one year, outside funding or grants in excess of $10,000 from Arthrex, Inc. Neither they nor a member of their immediate families received payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, division, center, clinical practice, or other charitable or nonprofit organization with which the authors, or a member of their immediate families, are affiliated or associated.

Methods: Fourteen fresh-frozen, paired cadaveric feet were dissected to expose the dorsal region. A registration marker triad consisting of three screws was fixed to the first cuneiform and the second metatarsal. A digitizer was utilized to record the three-dimensional positions of the registration markers and their displacement in test conditions before and after cutting of the Lisfranc ligament and after stabilization of the joint with either a suture button or a cannulated screw. The first and second cuneiforms and their metatarsals were removed, and the ligament attachment sites were digitized. Displacement at the Lisfranc ligament and the three-dimensional positions of the bones were determined.

Results: Loading with the Lisfranc ligament cut resulted in displacement that was significantly different from that after screw fixation (p = 0.0001), with a difference between means of 1.2 mm. Likewise, loading with the Lisfranc ligament cut resulted in a displacement that was significantly different from that after suture-button fixation (p = 0.0008), with a difference between means of 1.00 mm. No significant difference in displacement was found between specimens fixed with the suture button and those fixed with the screw.

Conclusions: Suture-button fixation can provide stability similar to that provided by screw fixation in cadaver specimens after isolated transection of the Lisfranc ligament.

Clinical Relevance: Fixation with a suture button may be an acceptable alternative to screw fixation in the treatment of isolated Lisfranc ligament injuries, avoiding subsequent surgery to remove the hardware prior to weight-bearing.

CiteULike    Connotea    Del.icio.us    Facebook    Technorati    Twitter    What's this?

Letters to the Editor:

Stanford University Libraries' HighWire Press (TM) assists in the publication of JBJS Online.
Copyright © 2009 by The Journal of Bone and Joint Surgery, Inc. Online ISSN: 1535-1386.
The Journal of Bone and Joint Surgery®, JBJS®, JB&JS®, and eJBJS® are registered in the U.S. Patent and Trademark Office.