The public defence will be held as a video conference over Zoom.
The defence will follow regular procedure as far as possible, hence it will be open to the public and the audience can ask ex auditorio questions when invited to do so.
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Due to copyright reasons, an electronic copy of the thesis must be ordered from the faculty. In order for the faculty to have time to process the order, it must be received by the faculty no later than 2 days prior to the public defence. Orders received later than 2 days before the defence will not be processed. Inquiries regarding the thesis after the public defence must be addressed to the candidate.
Digital Trial Lecture - time and place
Adjudication committee
- First opponent: Professor Stefan Rammelt, University Hospital Carl Gustav Carus, Dresden, Germany
- Second opponent: Associate Professor Tim Schepers, Amsterdam UMC, The Netherlands
- Third member and chair of the evaluation committee: Associate Professor Kristina Haugaa, Institute of Clinical Medicine, University of Oslo
Chair of defence
Professor II Pål Aksel Næss, Institute of Clinical Medicine, University of Oslo
Principal supervisor
Consultant Elisabeth Ellingsen Husebye, Oslo University Hospital
Summary
Lisfranc injuries are ligamentous and/or bony injuries to the midfoot. More advanced diagnostic methods as well as higher awareness of these injuries, seem to have increased the incidence compared to numbers previously reported. The Lisfranc injuries consist of a wide spectrum of injuries, ranging from severe fracture-dislocations to stable, non-displaced injuries. To differentiate the stable from the unstable injuries without obvious displacement can be challenging. Although there is agreement that the stable injuries should be treated nonoperatively, the literature reporting on the outcome after stable Lisfranc injuries is spars. Unstable Lisfranc injuries should be treated with anatomic reduction and stable fixation. The best method of fixation, however, is debated.
The aims of the thesis were to obtain a better understanding of Lisfranc injuries by studying the incidence and mechanisms of injury, as well as the outcome following nonoperative treatment of stable injuries and operative treatment of unstable injuries.
The first study was a cross-sectional study focusing on the incidence and mechanisms of injury as well as trying to determine predictors of instability. The incidence of Lisfranc injuries detected was higher than previously reported. Low-energy trauma was the most common mechanism of injury. Factors that increased the chance of having an unstable injury were intraarticular fractures in the two lateral tarsometatarsal joints, female gender and a shorter second tarsometatarsal joint height. The second study was a prospective cohort study examining the outcome after nonoperatively treated stable Lisfranc injuries. An excellent outcome was reported at the final follow-up at median 55 months after injury. The last study was a randomized controlled trial comparing arthrodesis to temporary bridge plate fixation of the first tarsometatarsal joint in unstable Lisfranc injuries. Both groups had good outcome scores and no method was found to be superior to the other with regards to the primary outcome score which was the American Orthopedic Foot and Ankle Score. The first metatarsal was better aligned in the group treated with temporary bridge plate fixation, but this group also had a high rate of radiologically detected osteoarthritis.
Additional information
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