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Orthopedic Trauma Directions 2008; 6(2): 23-32
DOI: 10.1055/s-2008-1038165
Clinical topic
© Georg Thieme Verlag Stuttgart · New York

Lisfranc joint injury

Comparison of open reduction and internal fixation with primary arthrodesis
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Publication History

Publication Date:
02 April 2008 (online)

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Summary

Evidence from two small comparative studies is insufficient to determine whether ORIF results in better outcomes compared with primary arthrodesis for the treatment of Lisfranc joint injury. Among patients with primarily ligamentous Lisfranc injury, functional outcomes and pain scores were worse for those treated by ORIF compared with arthrodesis and additional surgeries were significantly more common, based on a small single randomized controlled trial (RCT). Although no significant difference was found in anatomical reduction, after screw removal 75% of ORIF patients had loss of correction with increased degenerative changes.

For patients with severe fracture dislocations, no significant differences were found with respect to functional outcomes, anatomic reduction or need for revision procedures, based on one small retrospective cohort study. However 94% of ORIF patients had radiological signs of deterioration at the final follow-up.

Due to the relatively rare occurrence of this injury, multicenter studies are suggested.

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