الفهرس 
Aim of The WorkOnly 14 pages are availabe for public view
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Abstract
for dorsal plate fixation in acute Lisfranc injury at Kafr Elsheikh health insurance hospital and Adan hospital in Kuwait.
It involved 20 traumatic patients, their average age was 34 ±10 years. The majority of cases were males (70%). One fifth (20%) of the patients were smokers. Four patients (20%) were hypertensive and only two patients (10%) were diabetics. Regarding the mode of trauma, (50%) of causes were due to road traffic accidents, (20%) fall from a height, (15%) twisting, (10%) falling on stairs, and only one patient due to direct trauma. Concerning the affected side, (55%) were right sided and (45%) were left sided.
Half of patients (50%) were fixed using anatomical plate, while (40%) were fixed by miniplate and only two patients (10%) were fixed by variaxe distal radius plate. The majority of patients (80%) have no post operative complications while only four patients have complications (one complicated by deep venous thrombosis, one by Saudex atrophy, one had superficial infection and brocken screw and finally one had superficial wound wound infection and saudex atrophy). Only one patient has associated injury with ipsilateral tibial fixation. Bone injuries increase during summer months, mainly (June and July) which include (40%) of injuries, (20%) occur in each month. Median American orthopedic Foot and Ankle Society (AOFAS) score was 79 ranging from (65-90) and median FOOT and Ankle outcome score was 78 ranging from (64-89).
There is significant moderate to good negative correlation between age and AOFAS&FAOS (P value 0.001&0.014 respectively).
There is statistically significant lower AOFAS score among smokers compared to non smokers (P value 0.005). However, there is no statistically significant difference in AOFAS score in relation to gender, presence of comorbidities and mode of trauma P value (0.316, 0.170& 0.974 respectively).
There is statistically significant lower FAOS score among smokers compared to non-smokers (P value 0.005). However, there is no statistically significant difference in AOFAS score in relation to gender, presence of comorbidities and mode of trauma P value (0.212, 0.235& 0.908 respectively).
Plate fixation helps in preventing iatrogenic articular cartilage damage. Plates also have other advantages when compared to transarticular screws; if the screws break, distal threads are typically intra-articular and may contribute to further articular cartilage damage with movement and they are difficult to remove without additional significant damage. Whereas if a plate breaks in the joint, joint movement can still occur and it may not be necessary to remove it. If the screws inserted through the plate are broken, the distal threads would be left in the metatarsals or cuneiforms with no risk of more irritation of soft tissues or articular cartilage; or else they are easily accessible without contacting the joint, by specific instruments to remove screws. Vecchio et al. claim that the morbidity risk would be lower in plate fixation and weight-bearing can be achieved early on after surgery leading to less joint rigidity, muscle atrophy, and disuse osteopenia. (53)
Open reduction and internal fixation of Lisfranc injuries by plate(s) and screws may be a better way to fix such injuries in a rigid and anatomically reduced way.