Epidemiology
Over 40% of tarsometatarsal (TMT) dislocations were found to be related to traffic accidents, with more than 55% of injured individuals falling within the age range of 15 to 35 years, and males being injured more than twice as frequently [PMID:22560256].
Victims of falls, which disproportionately affected older individuals and a larger proportion of females, also contributed significantly to TMT dislocation cases [PMID:22560256].
Clinical Presentation
Based on the Hardcastle classification system, more than 60% of TMT dislocations were identified as partial (type B) injuries [PMID:22560256].
Management
A retrospective review of 61 patients with retained hardware post-ORIF of TMTJ fractures/dislocations showed that only 19.7% experienced hardware-related issues, suggesting that routine removal might not be essential [PMID:30850094].
Complications
In the study, older age correlated with lost reduction, and elevated BMI correlated with hardware failure, indicating these factors as potential risk indicators [PMID:30850094].
Patients with diabetes had an increased risk of postoperative infection without a corresponding higher risk of hardware failure [PMID:30850094].
References
1 VanPelt MD, Athey A, Yao J, Ennin K, Kassem L, Mulligan E et al.. Is Routine Hardware Removal Following Open Reduction Internal Fixation of Tarsometatarsal Joint Fracture/Dislocation Necessary?. The Journal of foot and ankle surgery : official publication of the American College of Foot and Ankle Surgeons 2019. link 2 Lievers WB, Frimenko RE, Crandall JR, Kent RW, Park JS. Age, sex, causal and injury patterns in tarsometatarsal dislocations: a literature review of over 2000 cases. Foot (Edinburgh, Scotland) 2012. link
2 papers cited of 3 indexed.