Comparison of two surgical techniques for Lisfranc injuries; closed reduction and fixation versus primary partial arthrodesis

ABSTRACT BACKGROUND: This study reviewed the outcomes of Lisfranc injuries treated by primary partial arthrodesis (PPA) or closed reduction and internal fixation (CRIF). METHODS: A retrospective review was made of patients who underwent PPA or CRIF for a Lisfranc injury after low-energy trauma, and follow-up was assessed according to radiographic, and clinical outcomes. A total of 45 patients with a median age of 38 years were followed up for an average of 47 months. RESULTS: The average American orthopaedic foot and ankle society (AOFAS) score was 83.6 points in the PPA group and 86.2 points in CRIF group (p>0.05). The mean pain score was 32.9 in the PPA group, 33.7 in the CRIF group (p>0.05). Secondary surgery for symptomatic hardware was required in 78% of the CRIF group and in 42% of the PPA group (p<0.05). CONCLUSION: Treatment of low-energy Lisfranc injuries with either PPA or closed reduction and fixation produced good clinical and radiological outcomes. The total AOFAS scores were comparable between two groups. However, the function and pain scores were seen to improve more with closed reduction and fixation while there was a greater requirement for secondary surgery in the CRIF group.

[1]  A. Budgen,et al.  A systematic review and meta-analysis of the treatment of acute lisfranc injuries: Open reduction and internal fixation versus primary arthrodesis. , 2020, Foot and ankle surgery : official journal of the European Society of Foot and Ankle Surgeons.

[2]  N. Kirzner,et al.  Primary arthrodesis versus open reduction internal fixation for complete Lisfranc fracture dislocations: a retrospective study comparing functional and radiological outcomes , 2019, ANZ journal of surgery.

[3]  N. Kirzner,et al.  Dorsal bridge plating or transarticular screws for Lisfranc fracture dislocations: A RETROSPECTIVE STUDY COMPARING FUNCTIONAL AND RADIOLOGICAL OUTCOMES , 2018, The bone & joint journal.

[4]  P. Tong,et al.  Open Reduction And Internal Fixation Versus Primary Partial Arthrodesis For Lisfranc Injuries Accompanied By Comminution Of The Second Metatarsal Base. , 2017, Acta orthopaedica Belgica.

[5]  G. Cochran,et al.  Primary Arthrodesis versus Open Reduction and Internal Fixation for Low-Energy Lisfranc Injuries in a Young Athletic Population , 2017, Foot & ankle international.

[6]  M. Tomlinson,et al.  The Role of Percutaneous Reduction and Fixation of Lisfranc Injuries. , 2017, Foot and ankle clinics.

[7]  T. Fernandes,et al.  EPIDEMIOLOGICAL STUDY ON LISFRANC INJURIES , 2017, Acta ortopedica brasileira.

[8]  M. Welck,et al.  Lisfranc injuries. , 2015, Injury.

[9]  Shimin Chang,et al.  Outcome comparison of Lisfranc injuries treated through dorsal plate fixation versus screw fixation , 2014, Acta ortopedica brasileira.

[10]  P. Giannoudis,et al.  The role of reduction and internal fixation of Lisfranc fracture–dislocations: a systematic review of the literature , 2010, International Orthopaedics.

[11]  Clifford B. Jones,et al.  Open Reduction Internal Fixation versus Primary Arthrodesis for Lisfranc Injuries: A Prospective Randomized Study , 2009, Foot & ankle international.

[12]  M. Myerson,et al.  Current management of tarsometatarsal injuries in the athlete. , 2008, The Journal of bone and joint surgery. American volume.

[13]  Thuan V Ly,et al.  Treatment of primarily ligamentous Lisfranc joint injuries: primary arthrodesis compared with open reduction and internal fixation. A prospective, randomized study. , 2006, The Journal of bone and joint surgery. American volume.

[14]  G. Dereymaeker,et al.  Severe Lisfrancs Injuries: Primary Arthrodesis or ORIF? , 2002, Foot & ankle international.

[15]  D. Perugia,et al.  Fracture dislocations of Lisfranc's joint treated with closed reduction and percutaneous fixation , 2002, International Orthopaedics.

[16]  M. Myerson.  The diagnosis and treatment of injury to the tarsometatarsal joint complex. , 1999, The Journal of bone and joint surgery. British volume.

[17]  B. M. Buzzard,et al.  Surgical management of acute tarsometatarsal fracture dislocation in the adult. , 1998, Clinical orthopaedics and related research.

[18]  S. Trevino,et al.  Controversies in tarsometatarsal injuries. , 1995, The Orthopedic clinics of North America.

[19]  J. Kenzora,et al.  Fracture Dislocations of the Tarsometatarsal Joints: End Results Correlated with Pathology and Treatment , 1986, Foot & ankle.