Return to sport following Lisfranc injuries: A systematic review and meta-analysis

Foot Ankle Surg. 2019 Oct;25(5):654-664. doi: 10.1016/j.fas.2018.07.008. Epub 2018 Aug 8.

Abstract

Background: Information regarding return rates (RR) and mean return times (RT) to sport following Lisfranc injuries remains limited.

Methods: A systematic search of nine major databases was performed to identify all studies which recorded RR or RT to sport following lisfranc injuries.

Results: Seventeen studies were included (n=366). For undisplaced (Stage 1) injuries managed nonoperatively (n=35), RR was 100% and RT was 4.0 (0-15) wks. For stable minimally-displaced (Stage 2) injuries managed nonoperatively (n=16), RR was 100% and RT was 9.1 (4-14) wks. For the operatively-managed injuries, Percutaneous Reduction Internal Fixation (PRIF) (n=42), showed significantly better RR and RT compared to both: Open Reduction Internal Fixation (ORIF) (n=139) (RR - 98% vs 78%, p<0.019; RT - 11.6 wks vs 19.6 wks, p<0.001); and Primary Partial Arthrodesis (PPA) (n=85) (RR - 98% vs 85%, p<0.047; RT - 11.6 wks vs 22.0 wks, p<0.002).

Conclusions: Stage 1 and stable Stage 2 Lisfranc injuries show good results with nonoperative management. PRIF offers the best RR and RT from the operative methods, though this may not be possible with high-energy injuries.

Level of evidence: IV. Systematic Review of Level I to Level IV Studies.

Keywords: Lisfranc; Mid-foot; Rate; Return; Sport; Tarso-metarsal; Time.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Foot Injuries / classification
  • Foot Injuries / therapy*
  • Foot Joints / injuries
  • Foot Joints / surgery
  • Fracture Dislocation / therapy
  • Fractures, Bone / therapy
  • Humans
  • Ligaments, Articular / injuries
  • Ligaments, Articular / surgery
  • Metatarsal Bones / injuries
  • Metatarsal Bones / surgery
  • Return to Sport*