Journal of Foot and Ankle Surgery (Asia Pacific)

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VOLUME 9 , ISSUE S1 ( August, 2022 ) > List of Articles

Original Article

Outcomes of Surgical Fixation of Lisfranc Injuries: A 2-year Review

Gideon JW Cheok, Akshay Padki, Kinjal V Mehta

Keywords : Foot and ankle, Lisfranc injury, Lisfranc surgical outcomes

Citation Information : Cheok GJ, Padki A, Mehta KV. Outcomes of Surgical Fixation of Lisfranc Injuries: A 2-year Review. J Foot Ankle Surg Asia-Pacific 2022; 9 (S1):S162-S167.

DOI: 10.5005/jp-journals-10040-1192

License: CC BY-NC 4.0

Published Online: 29-07-2022

Copyright Statement:  Copyright © 2022; The Author(s).


Aims/Background: Current literature recommends that unstable Lisfranc joint fracture-dislocations be treated with open reduction and internal fixation. There are limited regional data regarding the outcomes of surgical management of these injuries. The primary aim of our study is to explore patient-reported outcomes of surgically managed unstable Lisfranc injuries as limited locoregional data are detailing such outcomes. Secondarily, we aim to compare differences in outcomes between patients who had implants removed and those who retained their implants. Materials and methods: We performed a single-center, single-surgeon, retrospective review of 17 cases diagnosed with Lisfranc injuries treated surgically at our center from 2016 to 2017. Seventeen patients were followed up for an average of 24 months (range 21–34 months). Thirteen patients had their implants removed at an average of 5.9 months. Patients were assessed using Patient-reported Outcome Measures (SF-36), American Orthopaedic Foot and Ankle Society (AOFAS) Midfoot score, and Foot Function Index (FFI). Results: In our review, we found that the commonest type of repair was with transarticular screws. Of the 17 patients assessed, we derived a mean FFI score of 13.7% (scale of 0–100%, with a higher percentage indicating worse function and increased disability). Most patients showed decreased function with more strenuous activities. The average AOFAS midfoot score was 81.5, with most patients losing points for mild pain and limitations with recreational activities. The average SF-36 physical functioning score (PFS) was 80.9 (scale of 0–100, higher scores indicating better physical function), and the average SF-36 mental health score (MHS) was 95.8. Conclusion: In relation to available literature, the vast majority of our patients showed comparably good outcomes as measured using functional outcome and quality of life assessment scores.

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  1. Stavlas P, Roberts CS, Xypnitos FN, et al. The role of reduction and internal fixation of Lisfranc fracture-dislocations: a systematic review of the literature. Int Orthop 2010;34(8):1083–1091. DOI: 10.1007/s00264-010-1101-x
  2. Desmond EA, Chou LB. Current concepts review: Lisfranc injuries. Foot Ankle Int 2006;27(8):653–660. DOI: 10.1177/107110070602700819
  3. Rammelt S, Schneiders W, Schikore H, et al. Primary open reduction and fixation compared with delayed corrective arthrodesis in the treatment of tarsometatarsal (Lisfranc) fracture dislocation. J Bone Jt Surg - Ser B 2008;90(11):1499–1506. DOI: 10.1302/0301-620X.90B11.20695
  4. Hardcastle PH, Reschauer R, Kutscha-Lissberg E, et al. Injuries to the tarsometatarsal joint. Incidence, classification and treatment. J Bone and Joint Surg 1982;64–B(3):349–356. DOI: 10.1302/0301-620X.64B3.7096403
  5. Benirschke SK, Meinberg E, Anderson SA, et al. Fractures and dislocations of the midfoot: Lisfranc and Chopart injuries. J Bone Jt Surgery-American Vol 2012;94(14):1326–1337. DOI: 10.2106/JBJS.L00413
  6. Llopis E, Carrascoso J, Iriarte I, et al. Lisfranc injury imaging and surgical management. Semin Musculoskelet Radiol 2016;20(2): 139–153. DOI: 10.1055/s-0036-1581119
  7. Sripanich Y, Weinberg MW, Krähenbühl N, et al. Imaging in Lisfranc injury: a systematic literature review. Skeletal Radiol 2020;49(1):31–53. DOI: 10.1007/s00256-019-03282-1
  8. Mulier T, de Haan J, Vriesendorp P, et al. The treatment of lisfranc injuries: review of current literature. Eur J Trauma Emerg Surg 2010;36(3):206–216. DOI: 10.1007/s00068-010-1034-5
  9. Myerson MS, Fisher RT, Burgess AR, et al. Fracture dislocations of the tarsometatarsal joints: end results correlated with pathology and treatment. Foot Ankle 1986;6(5):225–242. DOI: 10.1177/107110078600600504
  10. Ren W, Li H, Lu J, et al. Undisplaced subtle ligamentous Lisfranc injuries, conservative or surgical treatment with percutaneous position screws? Chin J Traumatol 2019;22(4):196–201. DOI: 10.1016/j.cjtee.2019.03.005
  11. Arntz CT, Veith RG, Hansen ST. Fractures and fracture-dislocations of the tarsometatarsal joint. J Bone and Joint Surg 1988;70-A(2):173–181. DOI: 10.2106/00004623-198870020-00003
  12. Myerson M. The diagnosis and treatment of injuries to the Lisfranc joint complex. Orthop Clin North America 1989;20(4):655–664.
  13. Lau S, Guest C, Hall M, et al. Functional outcomes post lisfranc injury - transarticular screws, dorsal bridge plating or combination treatment? J Orthop Trauma 2017;31(8):447–452. DOI: 10.1097/BOT.0000000000000848
  14. Smith N, Stone C, Furey A. Does Open Reduction and Internal Fixation versus Primary Arthrodesis Improve Patient Outcomes for Lisfranc Trauma? A Systematic Review and Meta-analysis. Clin Orthop Relat Res 2016;474(6):1445–1452. DOI: 10.1007/s11999-015-4366-y
  15. Hu SJ, Chang SM, Li XH, et al. Outcome comparison of Lisfranc injuries treated through dorsal plate fixation versus screw fixation. Acta Ortop Bras 2014;22(6):315–320. DOI: 10.1590/1413-78522014220600576
  16. Kuo RS, Tejwani NC, Digiovanni CW, et al. Outcome after open reduction and internal fixation of Lisfranc joint injuries. J Bone Jt Surg - Ser A 2000;82(11):1609–1618. DOI: 10.2106/00004623-200011000-00015
  17. Kohli S, Srikantharajah D, Bajaj S. Clinical and radiological outcomes after open reduction and internal fixation of lisfranc injuries: a single centre experience. JOIO 2020;54(5):587–593. DOI: 10.1007/s43465-020-00066-x
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