FLATFOOT AS A LATE SEQUELA OF SUBTLE INJU RIES TO THE LISFRANC JOINT

In this retrospective study, 13 patients with subtle Lisfranc joint in juries were examined after a mean period of 23 months using clinical a ssessment, radiography and dynamic pedographic gait analysis. The aims were to identify the factors leading to a mobile flatfoot deformity, evaluate the functional and clinical outcome of these injuries, and dr aw practical conclusions for initial management and subsequent interve ntion. All patients showed a mobile flatfoot deformity, increased moti on in the subtalar joint, increased load on the hindfoot, decreased lo ad on the forefoot, and a prolonged contact phase during the stance ph ase. Radiographs revealed progressive osteoarthrosis in the joint and a residual displacement of the medial Lisfranc joint. An unstable medi al Lisfranc joint results in the development of a mobile flatfoot. Ini tial treatment of a subtly displaced Lisfranc joint should consist of exact anatomical reduction and additional maintenance of the longitudi nal arch of the foot. After failed initial treatment, early arthrodesi s of the midfoot is recommended as a salvage procedure for the foot.