Acta Ortopédica Mexicana

Orozco‑Villaseñor SL, Turrubiates‑Lucero E, Miguel-Andrés I, Martínez‑Rodríguez FJ, Mendoza‑Bañuelos E, Purata‑Kury RM, García‑Romo VM
Exposed dislocation of the first and second cuneiform bones and fracture in situ of the third cuneiform bone of the foot: Clinical case and literature review
Acta Ortop Mex 2019; 33 (4)

Language: Español
References: 22
Page: 256-260
PDF: 205.15 Kb.

[Fulltext - PDF]

ABSTRACT

Backgrounds: The isolated fracture/dislocation of the cuneiform bones is a not very frequent event and only a few cases have been reported in the literature. This type of event is presented as a variation of the Lisfranc injuries. The present report shows a rare clinical case of a patient with dislocation of the first and second cuneiform bones and fracture in situ of the third cuneiform bone of the left foot. Case report: A 49-year-old female patient presented severe traumatism of the dorsum of the foot with bony and soft tissue exposure as a result of a car accident. The patient underwent surgery in the emergency department consisting of surgical cleaning, debridement, reduction of dislocation of the first and second cuneiform bones and percutaneous fixation with 2.0 mm Kirschner wires. Results: After the surgery, the patient was found to be in good general condition, oriented without pain, stable, conscious, without traces of active bleeding from the wound and with the presence of Kirschner wires in an appropriate position. Discussion: An exhaustive inspection of the injury is recommended through the analysis of X-ray images, CT scans or magnetic resonance imaging, especially in unexposed lesions in order to apply the appropriate treatment and be able to achieve a prompt recovery of the patient.


Key words: Cuneiform bones, foot, dislocation, fracture.


REFERENCES

  1. Egol KA, Koval KJ, Zuckerman JD. Manual de fracturas. 5th ed. Madrid, España: Lippincott Williams and Wilkis. Wolters Kluwer Health; 2015.

  2. Olson RC, Mendicino SS, Rockett MS. Isolated medial cuneiform fracture: review of the literature and report of two cases. Foot Ankle Int. 2000; 21(2): 150-3.

  3. Fujita M, Yamamoto H, Kariyama K, Yamakawa H. Isolated plantar dislocation of the middle cuneiform: a case report. J Orthop Sci. 2003; 8(6): 875-7.

  4. Papanikolaou A, Maris J, Arealis G, Papadimitriou G, Charalambidis C. Dislocation of the lateral cuneiform. Report of two cases: one with dorsal and one with plantar displacement. Foot Ankle Surg. 2010; 16(4): e91-5.

  5. Guler F, Baz AB, Turan A, Kose O, Akalin S. Isolated medial cuneiform fractures: report of two cases and review of the literature. Foot Ankle Spec. 2011; 4(5): 306-9.

  6. Sargiotis NV, Korres N, Anagnostakos KD, Tsifetakis S, Baltopoulos P. An isolated dorsal dislocation of the lateral cuneiform. Foot Ankle Spec. 2015; 8(6): 525-8.

  7. Nashi M, Banerjee B. Isolated plantar dislocation of the middle cuneiform: a case report. Injury. 1997; 28(9-10): 704-6.

  8. Hei-Yan Tai D. Isolated medial cuneiform fracture: a case report and review of the literature. J Emerg Trauma Care. 2017; 2(1): 1-4. Available in: http: //www.imedpub.com/articles/isolated-medial-cuneiform-fracture-a-case-report-and-review-of-the-literature.pdf.

  9. Koun Yamauchi by, Miyake S, Kato C, Kato T. Isolated, nondisplaced medial cuneiform fractures: report of two cases. Foot Ankle. 2017; 10(2): 1-4.

  10. Eraslan A, Ozyurek S, Erol B, Ercan E. Isolated medial cuneiform fracture: a commonly missed fracture. BMJ Case Rep. 2013; 2013. pii: bcr2013010093.

  11. Kalia V, Fishman EK, Carrino JA, Fayad LM. Epidemiology, imaging, and treatment of Lisfranc fracture-dislocations revisited. Skeletal Radiol. 2012; 41(2): 129-36.

  12. Mehlhorn AT, Schmal H, Legrand MA, Südkamp NP, Strohm PC. Classification and outcome of fracture-dislocation of the cuneiform bones. J Foot Ankle Surg. 2016; 55(6): 1249-55.

  13. Desmond EA, Chou LB. Current concepts review: Lisfranc injuries. Foot Ankle Int. 2006; 27(8): 653-60.

  14. Saxby TS, Sharp RJ, Rosenfeld PF. Plantar fracture-dislocation of the intermediate cuneiform: case report. Foot Ankle Int. 2006; 27(9): 742-5. Available in: http: //journals.sagepub.com/doi/pdf/10.1177/107110070602700916.

  15. Miersch D, Wild M, Jungbluth P, Betsch M, Windolf J, Hakimi M. A transcuneiform fracture-dislocation of the midfoot. Foot. 2011; 21(1): 45-7.

  16. Doshi D, Prabhu P, Bhattacharjee A. Dorsal dislocation of the intermediate cuneiform with fracture of the Lisfranc joint: a case report. J Foot Ankle Surg. 2008; 47(1): 60-2.

  17. Scolaro J, Ahn J, Mehta S. In brief: Lisfranc fracture dislocations. Clin Orthop Relat Res. 2011; 469(7): 2078-80.

  18. Reinhardt KR, Oh LS, Schottel PC, Roberts MM, Levine D. Treatment of Lisfranc fracture-dislocations with primary partial arthrodesis. Foot Ankle Int. 2012; 33(1): 50-6.

  19. Wiley JJ. The mechanism of tarso-metatarsal joint injuries. J Bone Joint Surg Br. 1971; 53B(3): 474-82.

  20. Vuori JP, Aro HT. Lisfranc joint injuries: trauma mechanisms and associated injuries. J Trauma. 1993; 35(1): 40-5.

  21. Pinney SJ, Sangeorzan BJ. Fractures of the tarsal bones. Orthop Clin North Am. 2001; 3 2(1): 21-33. Available in: https://ac-els-cdn-com.ezproxy.conricyt.org/S0030589805701917/1-s2.0-S0030589805701917-main.pdf?_tid=49d5e97c-f40b-11e7-9bd2-00000aab0f6c&acdnat=1515371678_a7a1acae5a6ac0e5d6cfd0d2a181dec4.

  22. Aitken SA, Shortt N. Dorsomedial fracture dislocation of the first ray and medial cuneiform: a case report. J Foot Ankle Surg. 2012; 51(6): 795-7.