Outcomes after nonoperatively treated non-displaced Lisfranc injury: a retrospective case series of 55 patients

Ville T. Ponkilainen, Nikke Partio, Essi E. Salonen, Heikki-Jussi Laine, Heikki M. Mäenpää, Ville M. Mattila, Heidi H. Haapasalo

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Abstract

Background: Current knowledge of the role of the nonoperative treatment of Lisfranc injuries is based on a few retrospective case series. Hence, consensus on which patients can be treated nonoperatively does not exist. The aim of this study was to investigate outcomes after nonoperative treatment of Lisfranc injuries. Methods: In this study, patients were collected by recruiting all computer tomography-confirmed Lisfranc injuries treated during a 5-year period at a major trauma hospital. Between 2 and 6 years after suffering the injury, patients completed the visual analogue scale foot and ankle questionnaire. Results: In total, 55 patients returned adequately completed questionnaires and were included in the study. Of those, 22 patients had avulsion fractures and 33 had simple non-displaced intra-articular fractures. Of these patients, 30 (55%) scored over 90 points in both the pain and function subscales of the VAS-FA, and 35 (64%) scored over 90 points overall. In addition, three (5%) patients scored under 60 points in both the pain and function subscales of the VAS-FA, and four (7%) scored under 60 points overall. Only one patient with avulsion fractures underwent secondary surgery. Conclusion: Nonoperative treatment has a role in the treatment of Lisfranc injuries, and the results of our study support the view that avulsion and simple intra-articular fractures with < 2 mm of displacement can be treated nonoperatively with high functional outcomes. The results of nonoperative and operative treatment should be compared in a prospective randomized controlled study setting in future studies. Level of evidence: IV, retrospective case series.

Original languageEnglish
Pages (from-to)1311–1317
JournalArchives of Orthopaedic and Trauma Surgery
Volume141
Early online date22 Sep 2020
DOIs
Publication statusPublished - 2021
Publication typeA1 Journal article-refereed

Keywords

  • Conservative
  • Injury
  • Lisfranc
  • Nonoperative
  • Outcomes
  • Tarsometatarsal
  • Treatment

Publication forum classification

  • Publication forum level 1

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

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