We present the results of a multicentre retrospective study of closed fracture dislocations of the Lisfranc joint treated by closed reduction and percutaneous screw fixation (follow-up: almost 5 years). Forty-two patients that presented between 1994 and 1999 to the authors™ institutions were selected for this study (follow-up AOFAS score 81.0 ± 13.5). A review of the literature shows that opinions differ as to the most appropriate method of treatment, be it closed or open reduction, screws or K-wires fixation, but most of the authors agree that it is imperative to achieve anatomical reduction. In our study, no statistically significant differences could be detected when outcome scores of patients with anatomical reduction were compared with outcome scores of patients with nearly anatomical reduction, in both the combined fracture dislocation and pure dislocation subgroups. The conclusion is that even a nearly anatomical reduction is considered acceptable and predictive of a satisfactory outcome. Furthermore, we found a statistically significant difference in the AOFAS score between patients with combined fracture dislocations and pure dislocations, with the latter having a worse AOFAS score. This suggests that the ligament bone interface cannot heal with sufficient strength to regain stable long-term function.
