Treatment of Primarily Ligamentous Lisfranc Joint Injuries: Primary Arthrodesis Compared with Open Reduction and Internal Fixation<sbt aid="1080838">A Prospective, Randomized Study</sbt>

Abstract

A primary stable arthrodesis of the medial two or three rays appears to have a better short and medium-term outcome than open reduction and internal fixation of ligamentous Lisfranc joint injuries.

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

“…Certainly this brings a protocol bias to the positive outcome of increased hardware removal rates in the ORIF group. Even with this built-in removal from Henning, the rates here were similar to those of Ly et al [13] with CIs of 0.07 to 0.62 and 0.10 to 0.59, respectively. Also, three patients in the Henning group refused to undergo hardware removal if they were asymptomatic.…”

“…This protocol bias may have strongly influenced their removal rates. Ly et al [13] had similar removal rates without such a standard protocol. Second, only two of the three studies reported on hardware removal.…”

“…Incomplete statistical sets were available for a meta-analysis and this study could not be included. Complete statistical data were available for Ly et al [13], who used the AOFAS scale, and for Mulier who used the Baltimore Painful Foot score. Different scales were present; therefore, we assessed standard mean differences.…”

Lisfranc injuries

“…This author has treated all Lisfranc injuries with ORIF with primary arthrodesis over the past 10 years and has anecdotally noted a similar experience as Ly and Coetzee [11], with generally consistent pain relief and return to function relative to ORIF alone (Fig. 3a-c).…”

“…Initial studies suggested that over 90% of patients were able to return to pre-operative level of activity following primary arthrodesis [11] and that primary arthrodesis significantly reduced the rate of both planned and unplanned secondary surgeries relative to ORIF alone [12]. ORIF with primary arthrodesis also appears to yield good results for combined bony and ligamentous patterns [13].…”