Orthopaedic MD

Reports from Medscape Orthopaedics and Sports Medicine 1999
Ipsilateral femoral neck and shaft fractures
Fracture Healing in Tibia Fractures With an Associated Vascular Injury
The Treatment of Lisfranc Injuries
Open Fractures of the Patella: Long-term Functional Outcome

Discussion:
- injuries to cuboid may be accompanied by impaction with loss of bone stock;
Associated Injuries:
- navicular tuberosity fracture:
- Lisfranc fracture:
- midfoot/forefoot fractures:
- midtarsal injuries:
Wheeless' Textbook of Orthopaedics

Article by Robert Silbergleit, MD, Associate Professor, Department of Emergency Medicine, University of Michigan Medical School
Contents -Introduction Clinical Differentials Workup Treatment Medication Follow-up Miscellaneous Pictures Bibliography
Synonyms and related keywords: broken foot, toe fracture, broken toe, first metatarsal fracture, internal metatarsal fracture, fifth metatarsal fracture, proximal avulsion fracture, Jones fracture, Jones' fracture, fracture at Lisfranc joint, fracture at tarsometatarsal joint, talar fracture, navicular fractures, calcaneal fractures, March fracture, pseudo-Jones fracture, tennis fracture, posterior process fracture, Shepherd fracture, transchondral talar dome fracture, osteochondral talar dome fracture, intraarticular joint depression fracture, compartment syndrome

- involves fracture at base of fifth metatarsal at metaphyseal-diaphyseal junction, which typically extends into the 4-5 intermetatarsal facet;
- Jones fracture is located w/in 1.5 cm distal to tuberosity of 5th metatarsal & should not be confused w/ more common avulsion fracture of 5th metatarsal styloid;
Wheeless' Textbook of Orthopaedics

Jacques Lisfranc (1790-1847) was a field surgeon in Napoleon's army serving on the Russian front. He wrote about a new amputation technique to treat forefoot gangrene from frostbite. This technique involved a route following a series of joints to avoid having to take the time to cut through bone. This route became known as the Lisfranc joint. However, Lisfranc did not actually describe the injury pattern well known by this eponym.
Although the amputation technique survives, the term is used today to describe a wide spectrum of traumatic injuries to this distinct area of the foot. A Lisfranc injury encompasses everything from a sprain to a complete disruption of normal anatomy through these joints. Early recognition and treatment of this injury are important to preserve normal foot function.
Synonyms and related keywords: tarsometatarsal injuries, TMT injuries, Lisfranc dislocation, Lisfranc injury, midfoot injury
Author: John S Early, MD 2005

Lisfranc injuries occur at the midfoot, where a cluster of small bones forms an arch on top of the foot between the ankle and the toes. From this cluster, five long bones (metatarsals) extend to the toes. The second metatarsal also extends down into the row of small bones and acts as a stabilizing force. The bones are held in place by connective tissues (ligaments) that stretch both across and down the foot. However, there is no connective tissue holding the first metatarsal to the second metatarsal. A twisting fall can break or shift (dislocate) these bones out of place.
Contents - Symptoms, Diagnosis, Treatment

mechanism:
- because 2nd metatarsal is the longest metatarsal proximally, it will often be fractured at its base, with the other metatarsals dislocated;
- dorsal capsule of Lisfranc's joint, lacking sufficient reinforcement, will fail to support the load and will collapse, resulting in dorsal fracture dislocation of the metatarsal bases;
Wheeless' Textbook of Orthopaedics

Fractures in the foot are common, and the metatarsals are among the bones most commonly fractured. The injury may be an acute fracture, which is usually due to dropping of heavy objects on foot, or due to a stress fracture secondary to abnormal repetitive trauma in normal bone. Alternatively, a foot fracture can be an insufficiency fracture due to normal stress on a deficient bone.
Synonyms and related keywords: broken foot, Jones fracture, stress fracture of the foot, marcher's fractures, Lisfranc fracture dislocation, pseudo-Jones fracture, tennis fractures, dancer's fractures, pseudo-Jones fracture, Jones fractures, tennis fracture, dancer's fracture, Lisfranc dislocation, Torg classification, Stewart classification, zonal classification, metatarsal stress fracture, foot stress fracture, marcher's foot
Authors Rajiah & Karthikeyan 2005

With an increase in public interest in physical fitness, clinical practitioners are diagnosing stress fractures with greater frequency.1 First described by Aristotle in 200 BC, stress fractures were initially recorded in the medical literature in 1855 by the Prussian military physician Breithaupt, who described what is now known as a march fracture, or stress fracture of the metatarsals.
Synonyms and related keywords: march fracture, stress fracture of the metatarsals, foot fracture, foot stress fracture, broken foot, fractured foot, female athlete triad, Breithaupt fracture
Author: Andrew D Perron, MD 2007

Fifth metatarsal fracture patterns
Anatomy of the midfoot
Wheeless' Textbook of Orthopaedics

From the OTA Fracture and Dislocation Compendium

From the OTA Fracture and Dislocation Compendium - Toe Phalanx Fractures

From the OTA Fracture and Dislocation Compendium

From the OTA Fracture and Dislocation Compendium

A simple method for pedicle protection in flap surgery for posterior heel defects. Indian Journal of Plastic Surgery 36(2)2003