Lisfranc injuries describe a disruption of the Lisfranc ligament that connects two bones (the medial cuneiform and the second...
Evolution of Lisfranc Fixation
Suture bridge and other suspensory fixation methods typically refer to constructs that consist of a very strong piece of suture between two different structures. In the case of Lisfranc injuries this suture bridge holds the medial cuneiform and second metatarsal together.
The suture bridge itself can be held in place with either a metal plate sitting against the bone or with a screw in the bone. Suture bridge constructs are very versatile, and can be used in a number of ligament and tendon reconstructions as well as bony fixation.
The Arthrex InternalBrace system is a very versatile suture bridge construct consisting of very strong FiberTapeTM between a metal plate known as a cortical button and a bone anchor. In Lisfranc fixation the cortical button is passed through to the far side of the second metatarsal and the anchor placed in the medial cuneiform.
The suture is tightened in order to reduce and fix the injured joint. One of the major benefits of this construct is the lack of large plates or screws which can cause pain and may need to be removed at a later date. This procedure may also be performed through much smaller incisions than traditional methods, again leading to less pain.