Tape-Fixation for the Treatment of a Dorsal Boss in Lisfranc Joints of an Elderly Patient

TL;DR

An elderly patient with a painful foot deformity and arthritis successfully underwent surgery involving ligament tape and screw fixation, allowing her to return to golf.

Contribution

A successful surgical approach using semi-rigid fixation with ligament tape and an absorbable screw for treating dorsal bosses in elderly patients.

Findings

Osteophyte excision and semi-rigid fixation using ligament tape improved pain and deformity in an elderly patient.

The patient returned to recreational activities like golf within three months post-surgery.

The method preserved joint surfaces and allowed early societal reintegration.

Abstract

A dorsal boss, also known as a tarsal boss, is a bony prominence often associated with osteoarthritis (OA) of the tarsometatarsal (TMT) joints, leading to significant pain and a reduced quality of life (QOL) in elderly individuals. This condition frequently forces patients to abandon recreational activities and is typically resistant to conservative treatments. This report details a successful surgical intervention in an 83-year-old female patient with a dorsal boss and OA of the TMT joint, which involved osteophyte excision and semi-rigid fixation using ligament tape with an absorbable screw (Arthrex, Inc., Florida, USA). Post-surgery, the patient, who had experienced pain and deformity in the dorsal region of her right foot, showed significant improvement and returned to playing golf three months later.

This case underscores the significance of considering a semi-rigid, flexible dorsal fixation approach in elderly patients with dorsal bosses and associated joint instability while preserving joint surfaces and facilitating early reintegration into society. The patient’s favorable outcome highlights the potential advantages of this surgical method, particularly in managing dorsal boss cases that are resistant to conservative treatment.

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