Return to Sport after Surgical Treatment of Lisfranc Injuries in Athletes: A Retrospective Case Series

Abstract

Introduction
 A Lisfranc injury can be a devastating injury in athletes,and if inadequately treated, may lead to chronic pain and lossof function. The purpose of this study was to determine the rate andtime until return to sport after surgical fixation for a ligamentous Lisfrancinjury. We hypothesized that open reduction and screw fixationof a ligamentous Lisfranc injury can be a successful treatment in theathletic population and allow patients to return to sport at close totheir preinjury level of play.
 Methods
 All patients who were analyzed underwent repair of aligamentous Lisfranc injury with open reduction and screw fixationby a single surgeon, were between 18 - 40 years old at time of theirfinal follow up, and were identified as being an athlete (either recreationalor competitive). Eligible patients were given a questionnairethat included if they were able to return to sport, time until return tosport, subjective percentage of pre-injury level of play, current pain(0 - 10), and complications.
 Results
 Eleven patients were identified as athletes. Ten (91%) wereavailable for follow-up with a mean of 36.5 months (range, 14 - 60).The average age was 25.4 years (range, 15 - 37) at time of surgery.Eighty percent (8/10) were able to return to sport. The average timeuntil return to sport was 29.4 weeks (range, 22 - 52) with an averagesubjective value of their pre-injury level of play of 87% (range, 70 -100%). However, 67% (6/9) of the athletes had occasional pain withsport with an average pain level of 2.1 (range, 0 - 5). Two patientshad complications, a superficial infection and a deep vein thrombosis.
 Conclusion
 Most athletes were able to return to sport after undergoingopen reduction and internal fixation of a ligamentous Lisfrancinjury by less than 30 weeks post-surgery with a subjective value of87% of their previous function. However, the majority of the patientsalso experienced some residual pain with their respective sport.These findings suggested that athletes with a ligamentous Lisfrancinjury can have reliably good outcomes with operative repair.

Lisfranc Sports Injuries: What Do We Know So Far?

“…The literature strongly supports the idea that prompt and appropriate treatment of Lisfranc sports injuries causes most patients to return to their athletic activities [58]. Studies have consistently shown that individuals who receive proper treatment for these injuries can typically resume their activities within a mean timeframe of 28-35 weeks [58]. Moreover, they often achieve a level of performance comparable to their pre-injury status.…”

Return to Play, Performance, and Economic Analysis of National Football League Players After Lisfranc Injury

“…This finding is surprising, given the general belief that Lisfranc injuries have the potential to end athletic careers and result in chronic pain and loss of function. 21 Previous studies reporting on RTP after a Lisfranc injury in athletes have had similar or lower sample sizes. 2 , 11 , 16 , 18 , 21 Most Lisfranc injuries were experienced by offensive linemen (n = 8; 24.2%), followed by running backs (n = 7; 21.2%).…”

“… 21 Previous studies reporting on RTP after a Lisfranc injury in athletes have had similar or lower sample sizes. 2 , 11 , 16 , 18 , 21 Most Lisfranc injuries were experienced by offensive linemen (n = 8; 24.2%), followed by running backs (n = 7; 21.2%). The median RTP time was 11.0 months (IQR, 10.2-11.8).…”

Inconsistent radiographic diagnostic criteria for Lisfranc injuries: a systematic review

“…Further to the inconsistent radiographic diagnostic criteria observed, there were studies excluded during the literature search because these studies reported radiographic indications for surgery rather than diagnostic criteria [51][52][53]. The decision to exclude these studies was based on the fact that indication for surgery is inherently different from diagnosis criteria.…”