Primary open reduction and fixation compared with delayed corrective arthrodesis in the treatment of tarsometatarsal (Lisfranc) fracture dislocation

Rammelt, Stefan; Schneiders, Wolfgang; Schikore, H.; Holch, M.; Heineck, J.; Zwipp, H.

doi:10.1302/0301-620x.90b11.20695

Cited by 131 publications

(147 citation statements)

References 38 publications

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“…They pooled the results of all reported AOFAS scores within the literature and found the mean score to be 78.1. Since 2010, several case series have been published with mean scores similar or higher than that reported by Stavlas et al One other comparative trial was found comparing primary ORIF with delayed fusion [22]. This well-designed study compared the results of 22 primary fixations with 22 delayed fusions at a mean of 22 months postinjury.…”

Section: Discussionmentioning

confidence: 89%

Does Open Reduction and Internal Fixation versus Primary Arthrodesis Improve Patient Outcomes for Lisfranc Trauma? A Systematic Review and Meta-analysis

Smith

Stone

Furey

2016

Clinical Orthopaedics &Amp; Related Research

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Background Although Lisfranc injuries are uncommon, representing approximately 0.2% of all fractures, they are complex and can result in persistent pain, degenerative arthritis, and loss of function. Both open reduction and internal fixation (ORIF) and primary fusion have been proposed as treatment options for these injuries, but debate remains as to which approach is better. Questions/purposes We asked whether ORIF or primary fusion led to (1) fewer reoperations for hardware removal; (2) less frequent revision surgery; (3) higher patient outcome scores; and (4) more frequent anatomic reduction. Methods A systematic review was performed using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Three trials met the criteria for inclusion within the meta-analysis. Qualifying articles for the meta-analysis had data extracted independently by two authors (NS, AF). The quality of each study was assessed using the Center for Evidence Based Medicine's evaluation strategy; data were extracted from articles rated as good and fair: two and one article, respectively. Results The risk ratio for hardware removal was 0.23 (95% confidence interval [CI], 0.11-0.45; p \ 0.001) indicating more hardware removal for ORIF than fusion. For other revision surgery, the risk ratio for ORIF was 0.36 (95% CI, 0.08-1.59; p = 0.18) favoring neither. Similarly, neither was favored using patient-reported outcomes; the standard mean difference was calculated to be 0.50 (95% CI, À2.13 to 3.12; p = 0.71). When considering the risk of nonanatomic alignment, neither was favored (risk ratio, 1.48; 95% CI, p = 0.60). Conclusions The surgeon should consider the increased risk of hardware removal along with its associated morbidity and discuss this with the patient preoperatively when considering ORIF of Lisfranc injuries. Because no new trials have been performed since 2012, further randomized controlled trials will be needed improve our understanding of these interventions. Level of Evidence Level I, therapeutic study.

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Section: Discussionmentioning

confidence: 89%

Does Open Reduction and Internal Fixation versus Primary Arthrodesis Improve Patient Outcomes for Lisfranc Trauma? A Systematic Review and Meta-analysis

Smith

Stone

Furey

2016

Clinical Orthopaedics &Amp; Related Research

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“…A total of 11 papers satisfied the inclusion criteria and received critical analysis [2,11,17,21,23,30,31,33,34,38,39]. There were seven case series retrospective studies [2,17,30,31,33,38,39], two comparative cohort studies [23,34], and two prospective randomised control trials-comparative studies [11,21].…”

Section: Resultsmentioning

confidence: 99%

“…From the latter four studies only the data from the groups of patients who were treated by internal fixation were included in the review. In nine articles [2,11,17,21,23,30,33,34,39] there was no difference in the evaluation process, and in the remaining two papers [31,38] there was one point of difference in the quality scoring process, which was not significant.…”

Section: Resultsmentioning

confidence: 99%

“…The 11 papers [2,11,17,21,23,30,31,33,34,38,39] analysed in-depth reported 328 injuries in 325 patients (Table 1). Two hundred fifty-seven patients (79.0%) with 257 injuries (78.3%) were available for review.…”

Section: Clinical Datamentioning

confidence: 99%

“…Details about the nature and type of injury were given in eight papers [11,17,21,31,33,34,38,39] (Fig. 1).…”

Section: Clinical Datamentioning

confidence: 99%

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The role of reduction and internal fixation of Lisfranc fracture–dislocations: a systematic review of the literature

Stavlas

Roberts

Xypnitos

et al. 2010

International Orthopaedics (SICOT)

142

127

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A systematic review of the literature was performed in order to evaluate the role of reduction and internal fixation in the management of Lisfranc joint fracturedislocations. Articles were extracted from the Pubmed database and the retrieved reports were included in the study only if pre-specified eligibility criteria were fulfilled. Eleven articles were eligible for the final analysis, reporting data for the management of 257 patients. Injuries of the first three metatarsal rays were treated by closed reduction and internal fixation with screws in 16.3% of the patients, open reduction and internal fixation with screws in 66.5% and open reduction and internal fixation with Kirschner wires (K-wires) in 17.1% of the patients. The preferred method for the stabilisation of the fourth and fifth metatarsal rays was K-wires. Screw-related complications were common and were reported in 16.1% of the cases. The mean American Orthopaedic Foot and Ankle Society midfoot score was 78.1 points. Post-traumatic radiographic arthritis was reported in 49.6% of the patients, but only in 7.8% of them it was severe enough to warrant an arthrodesis. We conclude that open reduction and internal fixation of the first three metatarsal rays with screws is a reliable method for the management of Lisfranc injuries. This can be complemented by K-wires application in the fourth and fifth metatarsal rays if needed.

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Lisfranc Injuries

Elliot¹,

Jorgensen²,

Saxby³

2021

Evidence‐Based Orthopedics

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Primary open reduction and fixation compared with delayed corrective arthrodesis in the treatment of tarsometatarsal (Lisfranc) fracture dislocation

Cited by 131 publications

References 38 publications

Does Open Reduction and Internal Fixation versus Primary Arthrodesis Improve Patient Outcomes for Lisfranc Trauma? A Systematic Review and Meta-analysis

Does Open Reduction and Internal Fixation versus Primary Arthrodesis Improve Patient Outcomes for Lisfranc Trauma? A Systematic Review and Meta-analysis

The role of reduction and internal fixation of Lisfranc fracture–dislocations: a systematic review of the literature

Lisfranc Injuries

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