| Abstract: | IntroductionPediatric Lisfranc injuries are rare and a limited number of series or case reports have been published. Diagnosis can be easily missed and long-term outcome is not sufficiently presented. The primary aim of this paper is to review the literature about pediatric Lisfranc variants and equivalent injuries. This article also provides a review on Lisfranc joint anatomy, pediatric Lisfranc injuries, and stress or acute fractures involving the first and central (second to third) metatarsal (MT) bases, in an effort to detect potential pediatric Lisfranc variants and equivalent injuries, which were not accurately diagnosed.MethodsThe bibliographic survey to identify pediatric Lisfranc variants and equivalent injuries was conducted in the PubMed and Scopus databases, with no time limit. Four terms were used for searching in all possible combinations: Pediatric/children, Lisfranc/tarsometatarsal, variant/equivalent, injury/fracture. The only inclusion criterion was the age of the patients, which had to be less than 12 years. Reports on adolescents or adults were excluded.ResultsThe research indicated that there was only one study mentioning the pediatric Lisfranc equivalent injury, while there were no cases recorded as pediatric Lisfranc variants. The literature review regarding the final clinical outcome of both pediatric Lisfranc injuries and fractures, either stress or acute, involving the central MT base, indicated that early degenerative changes often occur, and may be responsible for chronic pain and activity limitation, even after mild and subtle low energy injuries.Discussion/ConclusionsThis review suggests that stress fractures involving the central MT base could be considered as a variant of the Lisfranc injury in children. Care should be taken to exclude occult fractures or ligamentous injuries to the medial and central Lisfranc joint complex in the presence of fractures involving the base or proximal portion of the first MT, including injuries to the physeal plate, to rule out the pediatric Lisfranc equivalent injury. |
