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Weightbearing Computed Tomography vs Conventional Tomography for Examination of Varying Degrees of Lisfranc Injures: A Systematic Review of the Literature.

Publication ,  Journal Article
Talaski, GM; Baumann, AN; Walley, KC; Anastasio, AT; de Cesar Netto, C
Published in: Foot Ankle Orthop
October 2023

BACKGROUND: Lisfranc injuries, if not accurately diagnosed, can result in chronic pain and instability. Previous studies have examined ultrasonographs, radiographs, magnetic resonance imaging (MRI), and conventional computed tomography (CT) scan to differentiate Lisfranc instability, but they focused on a healthy/injured scale without differentiating subtle injury. Weightbearing CT (WBCT) has emerged as a diagnostic tool for detecting subtle Lisfranc injuries. This systematic review aimed to compare WBCT with conventional CT in diagnosing Lisfranc injury, and the ability to differentiate injuries of varying severities. METHODS: The review encompassed PubMed, CINAHL, MEDLINE, SPORTDiscus, and Web of Science databases from inception until July 5, 2023. Inclusion criteria involved studies on CT and/or WBCT for Lisfranc injuries and nonoperative studies. Exclusion criteria composed case reports, commentaries, postoperative imaging studies, pediatric patients, studies with nonobjective radiographic measurements, studies exclusively focused on injury classification, and studies with fewer than 5 patients because of poor statistical power. Data extraction focused on radiographic measurements of the Lisfranc complex, categorized into conventional CT, partial WBCT, and total WBCT. RESULTS: Out of the initially retrieved 489 articles, 9 met the inclusion criteria. Several studies consistently demonstrate that WBCT provides a higher level of accuracy in measuring the Lisfranc area, offering enhanced sensitivity to detect subtle alterations in joint structure. Moreover, WBCT exhibits superior sensitivity in distinguishing between healthy Lisfranc joints and those with injuries, particularly when identifying dorsal ligament damage. This imaging modality allows for the detection of significant variations in critical measurements like first-second metatarsal (M1-M2) distance, first cuneiform (C1)-M2 distance, and joint volumes, enabling a more comprehensive assessment of Lisfranc joint health especially with subtle instability. CONCLUSION: This review evaluates the extant literature on WBCT's utility in diagnosing Lisfranc injuries and compares its effectiveness to CT in distinguishing between injuries of varying severity. WBCT, with reliable measurement techniques, appears more adept at detecting subtle Lisfranc instability compared to CT, likely by allowing the assessment of injury under load.

Duke Scholars

Published In

Foot Ankle Orthop

DOI

EISSN

2473-0114

Publication Date

October 2023

Volume

8

Issue

4

Start / End Page

24730114231209767

Location

United States
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Talaski, G. M., Baumann, A. N., Walley, K. C., Anastasio, A. T., & de Cesar Netto, C. (2023). Weightbearing Computed Tomography vs Conventional Tomography for Examination of Varying Degrees of Lisfranc Injures: A Systematic Review of the Literature. Foot Ankle Orthop, 8(4), 24730114231209770. https://doi.org/10.1177/24730114231209767
Talaski, Grayson M., Anthony N. Baumann, Kempland C. Walley, Albert T. Anastasio, and Cesar de Cesar Netto. “Weightbearing Computed Tomography vs Conventional Tomography for Examination of Varying Degrees of Lisfranc Injures: A Systematic Review of the Literature.Foot Ankle Orthop 8, no. 4 (October 2023): 24730114231209770. https://doi.org/10.1177/24730114231209767.
Talaski GM, Baumann AN, Walley KC, Anastasio AT, de Cesar Netto C. Weightbearing Computed Tomography vs Conventional Tomography for Examination of Varying Degrees of Lisfranc Injures: A Systematic Review of the Literature. Foot Ankle Orthop. 2023 Oct;8(4):24730114231209770.
Talaski, Grayson M., et al. “Weightbearing Computed Tomography vs Conventional Tomography for Examination of Varying Degrees of Lisfranc Injures: A Systematic Review of the Literature.Foot Ankle Orthop, vol. 8, no. 4, Oct. 2023, p. 24730114231209770. Pubmed, doi:10.1177/24730114231209767.
Talaski GM, Baumann AN, Walley KC, Anastasio AT, de Cesar Netto C. Weightbearing Computed Tomography vs Conventional Tomography for Examination of Varying Degrees of Lisfranc Injures: A Systematic Review of the Literature. Foot Ankle Orthop. 2023 Oct;8(4):24730114231209770.

Published In

Foot Ankle Orthop

DOI

EISSN

2473-0114

Publication Date

October 2023

Volume

8

Issue

4

Start / End Page

24730114231209767

Location

United States