GIẢI PHẪU ỨNG DỤNG PHỨC HỢP DÂY CHẰNG KHỚP LISFRANC

Abstract

Background: The Lisfranc joint ligament complex plays a critical role in maintaining the foot's arch. For Lisfranc fractures and dislocations, internal fixation methods typically lead to rather good outcomes. However, treatment options for isolated Lisfranc ligament injuries remain controversial. A thorough understanding of the Lisfranc ligament complex anatomy is essential for surgeons in selecting appropriate surgical approaches, especially for ligament reconstruction. There is still a lack of consensus in the anatomical descriptions of the Lisfranc ligament complex across various studies. Method: A descriptive cross-sectional study. Dissection of 36 feet from 18 fresh cadavers at the Department of Anatomy, University of Medicine and Pharmacy, Ho Chi Minh City, was conducted to expose the ligaments within the Lisfranc joint. The study described the macroscopic anatomical characteristics and structures of the Lisfranc ligament complex, measured the dimensions of each component, and examined their interrelations. Results: The average age of the sample was 67.9, with a male-to-female ratio of 1.25. The Lisfranc ligament complex is a constant structure comprising three components: the dorsal ligament, the plantar ligament, and the intermediate ligament. The dorsal ligament is located on the dorsal surface of the joint between the medial cuneiform and the second metatarsal, measuring 7.91 mm in length, 4.97 mm in width, and 1.2 mm in thickness. The plantar ligament runs from the anterior plantar surface on the lateral side of the medial cuneiform to the plantar surface of the second metatarsal, measuring 9 mm in length, 2.87 mm in width, and 1.27 mm in thickness. The intermediate ligament, also known as the Lisfranc ligament, is a bundle-shaped ligament attaching to the lateral surface of the medial cuneiform and the medial surface of the second metatarsal, measuring 7.89 mm in length, 3.38 mm in width, and 1.6 mm in thickness. Conclusion: The Lisfranc ligament complex is a constant structure with three parts: the dorsal, plantar, and intermediate ligaments. The intermediate ligament is the thickest and consists of 1 to 3 fascicles. The measurements and attachment points provide essential references for surgeons when selecting the appropriate reconstruction method.