We are reporting the results in a consecutive series of forty adults in
whom, between 1978 and 1984, forty-one tarsometatarsal
fracture-dislocations were treated with open reduction followed by
temporary internal fixation with AO screws. Ninety per cent of the patients
had an intra-articular or a periarticular fracture. An anatomical or nearly
anatomical reduction was achieved in all but a few patients, and there was
no loss of fixation or displacement. For thirty-four patients (thirty-five
injuries), the length of follow-up averaged 3.4 years, and a good or
excellent functional result was obtained in all but two of the thirty in
whom an anatomical reduction had been achieved. Of the six patients who had
a fair or a poor result, five had an associated grade-II or grade-III open
injury. The development of post-traumatic arthritis was directly related to
damage to the articular surfaces or to inadequate reduction, or to
both.