TY  - JOUR
A1  - Kösters, Clemens
A1  - Bockholt, Sebastian
A1  - Müller, Carsten
A1  - Winter, Corinna
A1  - Rosenbaum, Dieter
A1  - Raschke, Michael J.
A1  - Ochmann, Sabine
T1  - Comparing the outcomes between Chopart, Lisfranc and multiple metatarsal shaft fractures
JF  - Archives of Orthopaedic and Trauma Surgery
N2  - Objectives

Complex midfoot injuries could lead to severe functional impairment of mobility and quality of daily living. Aim of this study was to compare the clinical and functional outcomes of Chopart, Lisfranc fractures and multiple metatarsal shaft fractures.
Design

Retrospective case series.
Setting

Level one trauma center.
Intervention

Open or closed reduction and internal fixation with screws, K-wires, plates, external fixation or combination of different technics.
Main outcome measurements

The American Orthopaedic Foot and Ankle Society (AOFAS) Midfoot Score and the Maryland Foot Score were used to assess pain and functional outcome. 3D gait analysis, pedobarographic analysis and radiologic examinations were performed. The activity level was measured by a step counting accelerometer. All results were compared to an age-matched healthy control group.
Results

24 patients with a median age of 44 years (16–72) were included: 12 patients with multiple metatarsal shaft fractures, 6 patients with Chopart and 6 patients with Lisfranc fractures. The median follow-up was 2.6 years. The pedobarographic analysis reports reduced contact time of the total foot (p = 0.08), the forefoot (p = 0.008) and the hallux (p = 0.015) for the injured foot. A median score of 64 for the SF-36, 64 for the AOFAS Midfoot Score and 73 for the Maryland Foot Score indicated a poor restoration of foot function. Multiple metatarsal shaft fractures presented a significantly lower walking speed (p = 0.03) and cadence (p = 0.04).
Conclusion

The worst results were reported for multiple metatarsal shaft fractures on outcome scores, pedobarography, gait analysis and activity. Metatarsal serial fractures should not be underestimated as well as Chopart and Lisfranc fractures.
KW  - Multiple metatarsal fractures
KW  - Gait analysis
KW  - Pedobarography
KW  - Chopart
KW  - Lisfranc
Y1  - 2014
U6  - http://dx.doi.org/10.1007/s00402-014-2059-8
VL  - 134
SP  - 1397
EP  - 1404
ER  -