A Comparison of Complications and Reoperations Between Open Reduction and Internal Fixation Versus Primary Arthrodesis Following Lisfranc Injury

Abstract

There is a lack of consensus in the literature regarding optimal treatment methods for Lisfranc injuries, and recent literature has emphasized the need to compare open reduction and internal fixation (ORIF) with primary arthrodesis (PA). The purpose of the current study is to compare reoperation and complication rates between ORIF and PA following Lisfranc injury in a private, outpatient, orthopaedic practice. A retrospective chart review was performed on patients undergoing operative intervention for Lisfranc injury between January 2009 and September 2015. A total of 196 patients met the inclusion criteria (130 ORIF, 66 PA), with a mean follow-up of 61.3 and 81.7 weeks, respectively. The ORIF group had a higher reoperation rate than the PA group, due to hardware removal. When hardware removals were excluded, the reoperation rate was similar. Postsurgical complications were compared between the 2 groups with no significant difference. In conclusion, ORIF and PA had similar complication rates. When hardware removals were excluded, the reoperation rates were similar, although hardware removals were more common in the ORIF group compared with the PA group.

Levels of Evidence: Level III

Keywords

dislocation fracture fusion Lisfranc tarsometatarsal joint

Get full access to this article

View all access options for this article.

References

Goosens

De Stoop

. Lisfranc fracture dislocations: etiology, radiology, and result of treatment. A review of 20 cases. Clin Orthop Relat Res. 1983;176:154-162.

Myerson

Fisher

Burgess

Kenzora

. Fracture dislocations of the tarsometatarsal joints: end results correlated with pathology and treatment. Foot Ankle. 1986;6:225-242.

Arntz

Hansen

Jr . Dislocation and fracture dislocations of the tarsometatarsal joints. Orthop Clin North Am. 1987;18:105-114.

Arntz

Veith

Hansen

Jr . Fractures and fracture-dislocations of the tarsometatarsal joint. J Bone Joint Surg Am. 1988;70:173-181.

Trevino

Kodros

. Controversies in tarsometatarsal injuries. Orthop Clin North Am. 1995;26:229-238.

Granberry

Lipscomb

. Dislocation of the tarsometatarsal joints. Surg Gynecol Obstet. 1962;114:467-469.

Hardcastle

Reschauer

Kutscha-Lissberg

Schoffmann

. Injuries to the tarsometatarsal joint. J Bone Joint Surg Br. 1982;64:349-356.

Abbasian

Paradies

Weber

Krause

. Temporary internal fixation for ligamentous and osseous Lisfranc injuries: outcome and technical tip. Foot Ankle Int. 2015;36(8):976-983.

Kuo

Tejwani

DiGiovanni

, et al. Outcome after open reduction and internal fixation of Lisfranc joint injuries. J Bone Joint Surg. 2000;82-A(11):1609-1618.

10.

Stavlas

Roberts

Xypnitos

Giannoudis

. The role of reduction and internal fixation of Lisfranc fracture-dislocations: a systematic review of the literature. Int Orthop. 2010(34):1083-1091.

11.

Sangeorzan

Veith

Hansen

. Salvage of Lisfranc’s tarsometatarsal joint by arthrodesis. Foot Ankle Int. 1990;10:193-200.

12.

Henning

Jones

Sietsema

Bohay

Anderson

. Open reduction internal fixation versus primary arthrodesis for Lisfranc injuries: a prospective randomized study. Foot Ankle Int. 2009;30(1):913-921.

13.

Coetzee

. Treatment of primarily ligamentous Lisfranc joint injuries: primary arthrodesis compared with open reduction and internal fixation. J Bone Joint Surg Am. 2006;88(3):514-520.

14.

Cochran

Renninger Tompane

Bellamy

Kuhn

. Primary arthrodesis versus open reduction internal fixation for low-energy Lisfranc injuries in a young athletic population. Foot Ankle Int. 2017;38(9):957-963.

15.

VanPelt

Athey

Yao

, et al. Is routine hardware removal following open reduction internal fixation of tarsometatarsal joint fracture/dislocation necessary? J Foot Ankle Surg. 2019;58:226-230.