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Purpose <p>To investigate the clinical and radiographic outcomes of Lisfranc injuries treated with open reduction and internal fixation.</p> Methods <p>A retrospective cohort study reporting on the operative management of Lisfranc injuries was conducted across three institutions. Data from adult patients who sustained a tarsometatarsal joint fracture dislocation and were treated with open reduction and internal fixation from 1 January 2020 to 31 December 2023 were collected. The mean AOFAS midfoot score, the incidence of post-traumatic arthritis (PTA) and the complications were reported. The AOFAS score of anatomically reduced TMT joints was compared to the AOFAS score of the non-anatomically reduced TMT joints. The correlation of PTA to the quality of reduction was also evaluated.</p> Results <p>Thirty-six (36) consecutive adult patients were retrieved from the digital patient registry. Thirty-two (32) patients completed the six-month follow-up (FU) and were included in the study. The mean AOFAS score of the entire cohort was 89,44 (range 70–100). The anatomically reduced fractures demonstrated a mean AOFAS score of 91,41 (95% CI 88,14–94,68), whereas the mean AOFAS score of the non-anatomically reduced Lisfranc joints was 85,10 (95% CI 77,38–92,82). This difference was statistically significant (<i>p</i>-value: 0,031). Thirteen (13) of 32 patients (40,6%) developed PTA. PTA occurrence was strongly correlated to the quality of reduction (OR: 4,33, 95% CI 1,60–11,69, <i>p</i>-value &lt; 0,001). Four patients developed complex regional pain syndrome (CRPS), and broken implants were identified in four patients. One patient developed metatarsalgia, one deep infection and another one a painless flatfoot. High-energy injuries, PTA and obesity were the most important factors negatively affecting the outcome.</p> Conclusion <p>A better outcome and a lower risk of PTA were correlated with anatomically reduced Lisfranc fracture dislocations. The most commonly documented complications were PTA, implant breakage and CRPS.</p>

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Outcomes and complications after open reduction and internal fixation of Lisfranc injuries: a retrospective cohort study

  • 期刊论文

  • 发表日期：

    2025年6月23日

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  • Ioannis Stavrakakis,
  • Ioannis Sperelakis,
  • Konstantinos Zampetakis,
  • Alexandros Tsioupros,
  • Alkison Kotsis,
  • Alexandros Zikopoulos,
  • Orestis Konstantas,
  • Andreas F Mavrogenis,
  • Theodoros H. Tosounidis

摘要

Purpose

To investigate the clinical and radiographic outcomes of Lisfranc injuries treated with open reduction and internal fixation.

Methods

A retrospective cohort study reporting on the operative management of Lisfranc injuries was conducted across three institutions. Data from adult patients who sustained a tarsometatarsal joint fracture dislocation and were treated with open reduction and internal fixation from 1 January 2020 to 31 December 2023 were collected. The mean AOFAS midfoot score, the incidence of post-traumatic arthritis (PTA) and the complications were reported. The AOFAS score of anatomically reduced TMT joints was compared to the AOFAS score of the non-anatomically reduced TMT joints. The correlation of PTA to the quality of reduction was also evaluated.

Results

Thirty-six (36) consecutive adult patients were retrieved from the digital patient registry. Thirty-two (32) patients completed the six-month follow-up (FU) and were included in the study. The mean AOFAS score of the entire cohort was 89,44 (range 70–100). The anatomically reduced fractures demonstrated a mean AOFAS score of 91,41 (95% CI 88,14–94,68), whereas the mean AOFAS score of the non-anatomically reduced Lisfranc joints was 85,10 (95% CI 77,38–92,82). This difference was statistically significant (p-value: 0,031). Thirteen (13) of 32 patients (40,6%) developed PTA. PTA occurrence was strongly correlated to the quality of reduction (OR: 4,33, 95% CI 1,60–11,69, p-value < 0,001). Four patients developed complex regional pain syndrome (CRPS), and broken implants were identified in four patients. One patient developed metatarsalgia, one deep infection and another one a painless flatfoot. High-energy injuries, PTA and obesity were the most important factors negatively affecting the outcome.

Conclusion

A better outcome and a lower risk of PTA were correlated with anatomically reduced Lisfranc fracture dislocations. The most commonly documented complications were PTA, implant breakage and CRPS.