Dorsal Bridge Plate and Screw Fixation for Lisfranc Fracture in a 30-Year-Old Male: A Superior Alternative to K‑Wire Fixation

Abstract

Background: Lisfranc injuries are rare but serious mid-foot trauma involving the tarsometatarsal (TMT) joints. Precise anatomical reduction and stable fixation are crucial to prevent chronic dysfunction. Historically, K-wire fixation was standard, but newer studies support plate and screw constructs for better stability and outcomes.Case Presentation: A 30-year-old male sustained a Lisfranc fracture-dislocation with associated second metatarsophalangeal joint facture dislocation and third metatarsal shaft fracture after a motor vehicle accident. Surgical intervention was indicated.Methods: Open reduction and internal fixation were performed using a dorsal bridge plate and transarticular screw for the Lisfranc injury and K-wires for the additional fractures. This method ensured accurate reduction, stable fixation, and early mobilization, overcoming the common drawbacks of K-wire fixation such as limited stability and the need for implant removal.Results: Postoperative imaging confirmed anatomical alignment and stable hardware placement. The patient had uneventful healing, early mobilization, and excellent recovery, achieving an American Orthopaedic Foot and Ankle Society (AOFAS) mid-foot score of 85 at 12 months. No hardware complications were noted.Conclusion: Dorsal bridge plating with screw fixation offers distinct advantages over K-wires, including greater stability, reduced cartilage injury risk, and no need for secondary surgery. This technique presents an effective option for young active adults requiring Lisfranc fracture fixation.