Classification and Outcome of Fracture-Dislocation of the Cuneiform Bones

Alexander T Mehlhorn, Hagen Schmal, Maria Anna Legrand, Norbert P Südkamp, Peter C Strohm

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Resumé

Fractures and dislocations of the cuneiform bones are rare injuries to the midtarsal foot. The injury severity is often unclear, and the prognostic factors are unknown. The purpose of the present study was to characterize our insights of the diagnostics, therapy, and fracture patterns. We questioned whether the number of involved cuneiform bones and the type of injury would affect the clinical outcome. With this information, we aimed to develop a classification system for injuries of the cuneonavicular joint. Five patients who had sustained complex fracture-dislocation of the cuneiform bones were prospectively registered, underwent surgery, and were followed. We reviewed the published data and found 47 reports that included 55 patients to improve the informative value of our study. The injury mechanisms and therapy were evaluated, and the postoperative limitations and pain were assessed. The clinical outcome was correlated with the number of involved cuneiforms and the fracture/dislocation pattern. Direct trauma was associated with isolated fracture, and indirect injury was associated with isolated dislocations. Occasionally, these injuries were overlooked on conventional radiographs, and closed reduction frequently failed. The number of cuneiform bones involved and the type of injury were shown to affect the clinical outcome. We devised an easily applicable classification system for injuries to the cuneiform bones using this information. All cases were classified as isolated fractures (1), isolated dislocations (2), or fracture-dislocations (3) involving 1 (A), 2 (B), or 3 (C) cuneiform bones. The classification system we propose will facilitate a better understanding of the fracture patterns at the cuneonavicular joint line and is a good prognostic tool that requires validation in clinical settings.

OriginalsprogEngelsk
TidsskriftThe Journal of Foot & Ankle Surgery
Vol/bind55
Udgave nummer6
Sider (fra-til)1249-1255
ISSN1067-2516
DOI
StatusUdgivet - 2016
Udgivet eksterntJa

Fingeraftryk

Wounds and Injuries
Joints

Citer dette

Mehlhorn, Alexander T ; Schmal, Hagen ; Legrand, Maria Anna ; Südkamp, Norbert P ; Strohm, Peter C. / Classification and Outcome of Fracture-Dislocation of the Cuneiform Bones. I: The Journal of Foot & Ankle Surgery. 2016 ; Bind 55, Nr. 6. s. 1249-1255.
@article{289f90bf1d7340f5858b5c5a717602b4,
title = "Classification and Outcome of Fracture-Dislocation of the Cuneiform Bones",
abstract = "Fractures and dislocations of the cuneiform bones are rare injuries to the midtarsal foot. The injury severity is often unclear, and the prognostic factors are unknown. The purpose of the present study was to characterize our insights of the diagnostics, therapy, and fracture patterns. We questioned whether the number of involved cuneiform bones and the type of injury would affect the clinical outcome. With this information, we aimed to develop a classification system for injuries of the cuneonavicular joint. Five patients who had sustained complex fracture-dislocation of the cuneiform bones were prospectively registered, underwent surgery, and were followed. We reviewed the published data and found 47 reports that included 55 patients to improve the informative value of our study. The injury mechanisms and therapy were evaluated, and the postoperative limitations and pain were assessed. The clinical outcome was correlated with the number of involved cuneiforms and the fracture/dislocation pattern. Direct trauma was associated with isolated fracture, and indirect injury was associated with isolated dislocations. Occasionally, these injuries were overlooked on conventional radiographs, and closed reduction frequently failed. The number of cuneiform bones involved and the type of injury were shown to affect the clinical outcome. We devised an easily applicable classification system for injuries to the cuneiform bones using this information. All cases were classified as isolated fractures (1), isolated dislocations (2), or fracture-dislocations (3) involving 1 (A), 2 (B), or 3 (C) cuneiform bones. The classification system we propose will facilitate a better understanding of the fracture patterns at the cuneonavicular joint line and is a good prognostic tool that requires validation in clinical settings.",
author = "Mehlhorn, {Alexander T} and Hagen Schmal and Legrand, {Maria Anna} and S{\"u}dkamp, {Norbert P} and Strohm, {Peter C}",
note = "Copyright {\circledC} 2016 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.",
year = "2016",
doi = "10.1053/j.jfas.2016.01.019",
language = "English",
volume = "55",
pages = "1249--1255",
journal = "The Journal of Foot & Ankle Surgery",
issn = "1067-2516",
publisher = "W.B.Saunders Co.",
number = "6",

}

Classification and Outcome of Fracture-Dislocation of the Cuneiform Bones. / Mehlhorn, Alexander T; Schmal, Hagen; Legrand, Maria Anna; Südkamp, Norbert P; Strohm, Peter C.

I: The Journal of Foot & Ankle Surgery, Bind 55, Nr. 6, 2016, s. 1249-1255.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

TY - JOUR

T1 - Classification and Outcome of Fracture-Dislocation of the Cuneiform Bones

AU - Mehlhorn, Alexander T

AU - Schmal, Hagen

AU - Legrand, Maria Anna

AU - Südkamp, Norbert P

AU - Strohm, Peter C

N1 - Copyright © 2016 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

PY - 2016

Y1 - 2016

N2 - Fractures and dislocations of the cuneiform bones are rare injuries to the midtarsal foot. The injury severity is often unclear, and the prognostic factors are unknown. The purpose of the present study was to characterize our insights of the diagnostics, therapy, and fracture patterns. We questioned whether the number of involved cuneiform bones and the type of injury would affect the clinical outcome. With this information, we aimed to develop a classification system for injuries of the cuneonavicular joint. Five patients who had sustained complex fracture-dislocation of the cuneiform bones were prospectively registered, underwent surgery, and were followed. We reviewed the published data and found 47 reports that included 55 patients to improve the informative value of our study. The injury mechanisms and therapy were evaluated, and the postoperative limitations and pain were assessed. The clinical outcome was correlated with the number of involved cuneiforms and the fracture/dislocation pattern. Direct trauma was associated with isolated fracture, and indirect injury was associated with isolated dislocations. Occasionally, these injuries were overlooked on conventional radiographs, and closed reduction frequently failed. The number of cuneiform bones involved and the type of injury were shown to affect the clinical outcome. We devised an easily applicable classification system for injuries to the cuneiform bones using this information. All cases were classified as isolated fractures (1), isolated dislocations (2), or fracture-dislocations (3) involving 1 (A), 2 (B), or 3 (C) cuneiform bones. The classification system we propose will facilitate a better understanding of the fracture patterns at the cuneonavicular joint line and is a good prognostic tool that requires validation in clinical settings.

AB - Fractures and dislocations of the cuneiform bones are rare injuries to the midtarsal foot. The injury severity is often unclear, and the prognostic factors are unknown. The purpose of the present study was to characterize our insights of the diagnostics, therapy, and fracture patterns. We questioned whether the number of involved cuneiform bones and the type of injury would affect the clinical outcome. With this information, we aimed to develop a classification system for injuries of the cuneonavicular joint. Five patients who had sustained complex fracture-dislocation of the cuneiform bones were prospectively registered, underwent surgery, and were followed. We reviewed the published data and found 47 reports that included 55 patients to improve the informative value of our study. The injury mechanisms and therapy were evaluated, and the postoperative limitations and pain were assessed. The clinical outcome was correlated with the number of involved cuneiforms and the fracture/dislocation pattern. Direct trauma was associated with isolated fracture, and indirect injury was associated with isolated dislocations. Occasionally, these injuries were overlooked on conventional radiographs, and closed reduction frequently failed. The number of cuneiform bones involved and the type of injury were shown to affect the clinical outcome. We devised an easily applicable classification system for injuries to the cuneiform bones using this information. All cases were classified as isolated fractures (1), isolated dislocations (2), or fracture-dislocations (3) involving 1 (A), 2 (B), or 3 (C) cuneiform bones. The classification system we propose will facilitate a better understanding of the fracture patterns at the cuneonavicular joint line and is a good prognostic tool that requires validation in clinical settings.

U2 - 10.1053/j.jfas.2016.01.019

DO - 10.1053/j.jfas.2016.01.019

M3 - Journal article

VL - 55

SP - 1249

EP - 1255

JO - The Journal of Foot & Ankle Surgery

JF - The Journal of Foot & Ankle Surgery

SN - 1067-2516

IS - 6

ER -