Instabilidade sutil da articulação de Lisfranc

novas tendências

Abstract

The subtle instability of the Lisfranc joint is a lesion often underdiagnosed, going unnoticed in up to 40% of cases. Failure to diagnose this type of injury can have serious repercussions such as chronic pain, functional losses, deformities, residual joint instability and the dreaded arthrosis. The movements performed in this joint, despite amplitudes inferior to those performed by the surrounding joints, are extremely important in the biomechanics of the foot. There is still much debate as to what would be the best method for treating these lesions. The treatments available today can be divided between those who use methods for joint fixation, definitive or not, and those that use methods for ligament reconstruction of the Lisfranc joint. Methods for joint reconstruction arose from the concept that it is not reasonable for an unstable joint to be fixed by transarticular screws or plates, or even arthrodesed, in the expectation of a physiological ligament cure. Preserving joints and rebuilding ligaments, in addition to being based on a more reasonable premise, can prevent joint degeneration, restoring regional joint stability. Ideally, durable yet flexible implants can potentially provide an environment that not only brings stability but is also dynamic enough to seek to approximate and reproduce the normal physiology needed to provide healing and ligament strength.