Outcomes of Lisfranc Injuries Treated with Joint-Preserving Fixation

Abstract

Background

Open reduction and internal fixation (ORIF) with transarticular screws to stabilize Lisfranc injuries may increase the risk of arthritis or affect outcomes. Joint-preserving fixation using staples, bridge plating, or Lisfranc screws avoids iatrogenic articular damage. This study analyzes functional outcomes and complications in Lisfranc-injury patients who underwent joint-preserving fixation.

Materials and Methods

We conducted a retrospective review of patients treated for Lisfranc injury at a Level 1 trauma center from July 2008 to October 2015. Patients over 18 years of age, with no concomitant procedures in the lower extremities, were included. Functional outcomes were evaluated through American Orthopaedic Foot and Ankle Society (AOFAS) scores.

Results

Fourteen patients met the inclusion criteria. The average followup time was 57 months (range 22-102 months). AOFAS scores averaged 80.4 (standard deviation [SD] 16) at the time of the latest followup, with time to return to regular activities averaging 34 weeks (SD 25 weeks). Five patients had their hardware removed, and two required subsequent fusion during the followup period. The single complication involved a screw backing out, with subsequent removal.

Conclusions

In this case series, joint-preserving fixation for Lisfranc injuries offered similar AOFAS scores as those reported for ORIF with transarticular screws but with a decreased rate of hardware removal and need for midfoot fusion.

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Acknowledgments

We would like to thank Sean Bender, MD, for his assistance with the investigation and data curation.

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form, the patients have given their consent for their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.

Financial support and sponsorship

Nil.

Conflicts of interest

Vinod Panchbhavi is a consultant for Stryker Orthopaedics as well as an editor for Lippincott Williams and Wilkins Publishing.

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Correspondence to Kenrick C Lam.

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Scofield, H.O., Lam, K.C., Stautberg, E.F. et al. Outcomes of Lisfranc Injuries Treated with Joint-Preserving Fixation. JOIO (2020). https://doi.org/10.1007/s43465-020-00070-1

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Keywords

  • American Orthopaedic Foot and Ankle Society
  • clinical outcomes
  • dorsal plating
  • Lisfranc
  • midfoot