A comparative study of surgical outcomes between fresh injury and obsolete injury of the tarsometatarsal joint

YU Xiao; JIANG Lu-yong; LIU Bing-gen; PANG Qing-jiang; YANG Chang-chun

doi:10.3969/j.issn.2095-252X.2015.02.007

Abstract：Objective To compare the surgical outcomes between fresh injury and obsolete injury of the tarsometatarsal joint. Methods From October 2010 to October 2013, 22 patients with tarsometatarsal joint injuries were adopted. Among them, 10 patients with fresh injuries of the tarsometatarsal joint underwent open reduction and internal ifxation within 7 days after injuries. The other 12 patients with obsolete injuries of the tarsometatarsal joint were misdiagnosed at 4-24 weeks after injuries, and then underwent open reduction and internal fixation or tarsometatarsal joint arthrodesis. All the patients were followed up for a mean period of 24 months ( range: 12-48 months ). The foot function was evaluated by the American Orthopedic Foot and Ankle Society ( AOFAS ) midfoot score system. Results The mean AOFAS score was 94.08 in fresh injury group and 79.92 in obsolete injury group. The fresh injury group was superior to the obsolete injury group in the scores of pain, range of motion ( ROM ) and walking distance ( P<0.05 ). The main cause of obsolete injury was the misdiagnosis by emergency physicians at the ifrst visit. Conclusions As long as accurate anatomical reduction and good ifxation are achieved, more satisfactory results can be obtained in the patients with fresh tarsometatarsal joint injuries than in the patients with obsolete injuries. However, pain can also be significantly relieved and function can be improved with open reduction and internal fixation or arthrodesis in the patients with obsolete tarsometatarsal joint injuries.