Lisfranc fracture-dislocation treated with a nickel-titanium shape memory alloy nail angle fixator: A retrospective case study

Abstract BACKGROUND: To investigate the clinical efficacy of a nickel-titanium (Ni-Ti) memory alloy nail angle fixator in the treatment of Lisfranc fracture-dislocation. METHODS: A retrospective case study was carried out to analyze the clinical data of seven patients (4 male; 3 female) aged 23–60 years [(44 ± 12.5) years] with Lisfranc fracture-dislocation admitted to the 920 Hospital of the People's Liberation Army Joint Logistic Support Force between November 2018 and April 2022. All injuries were fresh and closed and there were 3 cases observed in the left foot and 4 in the right foot. The Myerson classification of the fractures showed: 1 case of type A, 2 cases of type B1, 3 cases of type B2, and 1 case of type C1. Open reduction and internal fixation were performed using a Ni-Ti shape memory alloy nail angle fixator. The affected feet were observed for complications and fracture-dislocation healing. Foot function was assessed using the Visual Analogue Score for pain (VAS) and the American Orthopedic Foot and Ankle Society (AOFAS) Midfoot Scale. RESULTS: Patients were followed-up for 9–48 months, with a mean follow-up period of 18.9 months. One Myerson A patient had a broken Lisfranc screw that was used to remove the internal fixation, however, the broken part was not removed. There were no other abnormalities in the remaining patients. Radiography indicated normal longitudinal arch morphology and good anatomical alignment of the foot joints in all seven patients. At the final follow-up, VAS scores ranged from 0–3 with a mean of 1.7, and AOFAS scores ranged from 85–97 with a mean of 90.6. There were 5 cases of excellent healing and 2 cases of good healing, with a satisfactory rating of 100%. CONCLUSION: The procedure of using a Ni-Ti shape memory alloy nail angle fixator to treat Lisfranc fracture-dislocation is relatively simple with good fixation of the fracture-dislocation, satisfactory postoperative functional recovery of the foot, effective pain relief, and few surgical complications, thereby offering a novel option for clinical treatment.