OUTCOME OF OPERATIVE TREATMENT OF LISFRANC INJURIES

Abstract

Introduction: Lisfranc injuries account for 0.2% of all fractures. Around 20% of these injuries are missed or misdiagnosed leading to long term problems with the foot. Early recognition and treatment of these injuries are crucial in restoring the function of the foot.

Aim: To review the functional outcome of patients following surgery for lisfranc injuries.

Methodology: This is a retrospective review of patients treated surgically for lisfranc injury in our hospital between January 2000 and January 2007. There were 13 patients whose records were reviewed and data including age, mechanism of injury, associated injuries, surgery performed, and peri-operative complications were collected. A telephonic survey was conducted to find out the current functional and employment status. AOFAS mid-foot score was used to evaluate the outcome.

Results: 13 patients were included in the study. Mean age was 31 years at the time of injury. 5 patients were female and 8 male. 10 had injury on the left foot while 3 had on the right. 11 were closed lisfranc injury. 10 patients had isolated lisfranc injury. Seven patients had sustained lisfranc injury following a fall, while three had a road traffic accident. Six patients had a homo-lateral, four had isolated and two had divergent type. Nine patients had trans-articular fixation, seven of whom had open reduction and internal fixation while two had K-wire fixation. Extra-articular fixation was done in four patients. Average AOFAS mid foot scoring was 80 ranging from 47 to 100. Lower scores were related to pain. Nine patients were pain free at follow up and returned to work. Average follow-up period was 32.6 months (range5–77 months)

Conclusion: Two thirds of patients with a Lisfranc fracture dislocation return to work and extra-articular fixation may result in superior outcomes compared with the traditional methods.