Clinical Value of Nunley Classification in the Treatment for Low Energy Lisfranc Injury

Objective To discuss the clinical value of Nunley Classification in the treatment for low energy Lisfranc injury.Methods From January,2007 to December,2008,24 patients of low energy Lisfranc injury have undergone therapies.There were 19 male and 5 female cases 24 with an average age of 37.7.There were left side of injuries in 13 cases,the right side in 11 cases,sprain in 7 cases,sports injuries in 17cases.All 24 cases were recent in injuries.In accordance with Nunley Standard Classification,5 cases were classified into Type I,11 cases Type Ⅱ,and 8 cases type Ⅲ.Moreover,one of all cases had a complication with scaphoid fracture,3 cases with cuboid fracture,8 cases with cuneiform fracture and 13 cases with metatarsus fracture.7 cases had received conservative therapies as plaster fixations,one case had been applied with closed reduction with percutaneous Kirschner internal fixation and 16 cases had received open reductions with internal fixations.The instruments for internal fixations include hollowed screwed nail,Kirschner and Low modulus micro-plate.Results 23 cases had been followed up for an average of 33.8 months,ranging from 18 to 54 months.According to the assessment of efficacy for Foot by AOFAS,13 cases ere classified to excellence level by taking a percentage of 56.5,7 cases to good level by 30.4%,1 case to approval level by 4.3% and 2 cases to failed level by 4.3%.Conclusion Nunley Standard Classification has a important clinical guidance in the therapy for low energy Lisfranc injury.It will present a satisfying result to acquire an accurate pre-operative diagnosis,reach intra-operative anatomical reduction with suitable internal fixation to maintain the length of force and morphology of vertical foot arch.As for those argumentative cases of Type Ⅱ injuries,the operative therapies show a better efficacy than the conservative treatments.