Anatomic study on the reconstruction of ligaments between the first cuneiform and second metatarsal base
LIU Song-bo, HUANGD Dong, WEI Bao-fu,HUANG Yong-jun, LIU Xiao-chun
Chinese Journal of Clinical Anatomy ›› 2016, Vol. 34 ›› Issue (2) : 126-129.
Anatomic study on the reconstruction of ligaments between the first cuneiform and second metatarsal base
Objective Morphological measurements of Lisfranc ligament complex were made to provide anatomical basis for ligament reconstruction. Methods 8 fresh adult cadaver foot specimens were dissected. The length, width and area of the ligaments between the medial cuneiform(C1) and second metatarsal base (M2), including dorsal ligament, plantar ligament and Lisfranc ligament, the distance from the articular surface of Lisfranc ligament, and the angle of Lisfranc ligament were measured and analyzed， respectively. According to the measurement results, bone tunnel between the first cuneiform and second metatarsal base was established. Results Lisfranc ligament was the largest among the three ligaments, The lengths,widths and area were (9.11~12.03 mm), (7.36~10.16 mm), (92.01~120.01 mm²)，respectively. Lisfranc bone tunnel: the entry point was (8.25~11.22 mm) from C2-M2 joint; the angle was consistent with the Lisfranc ligament course, which was (39.2°~47.6°) degrees to the sagittal plane and (12.5°~19.8°) degrees to horizontal plane; the exit point was Lisfranc ligament origin of the first cuneiform. Conclusion Lisfranc is the most robust among the three ligaments. The bone tunnel of reconstruction is established for the formation of Lisfranc ligament and dorsal ligament in accordance with Lisfranc ligament angle and attachment. Since the position of plantar ligament is deep, the reconstruction is close to approximate anatomical reconstruction due to the technical limitations.
Lisfranc ligament / Applied anatomy / Bone tunnel / Ligament reconstruction
[1] Nunley JA, Vertullo CJ. Classification, investigation, and management of midfoot sprains: Lisfranc injuries in the athlete[J]. Am J Sports Med, 2002, 30(6):871-878.
[2] Boffeli TJ, Pfannenstein RR, Thompson JC. Combined medial column primary arthrodesis, middle column open reduction internal fixation, and lateral column pinning for treatment of Lisfranc fracture-dislocation injuries[J]. Foot Ankle Surg, 2014, 53(5):657-663.
[3] Johnson A, Hill K, Ward J, et al. Anatomy of the lisfranc ligament[J]. Foot Ankle Spec, 2008, 1(1):19-23.
[4] Kura H, Luo ZP, Kitaoka HB, et al. Mechanical behavior of the Lisfranc and dorsal cuneometatarsal ligaments: in vitro biomechanical study[J]. J Orthop Trauma, 2001, 15(2):107-110.
[5] Solan MC, Moorman CR, Miyamoto RG, et al. Ligamentous restraints of the second tarsometatarsal joint: a biomechanical evaluation[J]. Foot Ankle Int, 2001, 22(8):637-641.
[6] Sands AK, Grose A. Lisfranc injuries[J]. Injury, 2004, 35（Suppl 2）:B71-B76.
[7] Crim J. MR imaging evaluation of subtle Lisfranc injuries: the midfoot sprain[J]. Magn Reson Imaging Clin N Am, 2008,16(1):19-27.
[8] 李春光，俞光荣，李兵，等. 内侧楔骨与第2跖骨底间韧带的解剖研究及临床意义[J]. 中国临床解剖学杂志, 2012, 30(2):119-122.
[9] Marsland D, Belkoff SM, Solan MC. Biomechanical analysis of endobutton versus screw fixation after Lisfranc ligament complex sectioning[J]. Foot Ankle Surg, 2013, 19(4):267-272.
[10] 田竞，周大鹏，于海龙，等. 双Endobutton治疗单纯Lisfranc韧带损伤[J]. 中华创伤骨科杂志, 2012, 14(9):752-754.
[11] Nery C, Ressio C, Alloza JF. Subtle Lisfranc joint ligament lesions: surgical neoligamentplasty technique[J]. Foot Ankle Clin, 2012,17(3):407-416.
[12] Hirano T, Niki H, Beppu M. Newly developed anatomical and functional ligament reconstruction for the Lisfranc joint fracture dislocations: a case report[J]. Foot Ankle Surg, 2014, 20(3):221-223.
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