Outcome after nonoperative treatment of stable Lisfranc injuries. A prospective cohort study

Are H Stødle; Kjetil H Hvaal; Helga Brøgger; Jan Erik Madsen; Elisabeth Ellingsen Husebye

doi:10.1016/j.fas.2021.03.017

Outcome after nonoperative treatment of stable Lisfranc injuries. A prospective cohort study

Foot Ankle Surg. 2022 Feb;28(2):245-250. doi: 10.1016/j.fas.2021.03.017. Epub 2021 Mar 27.

Authors

Are H Stødle¹, Kjetil H Hvaal², Helga Brøgger³, Jan Erik Madsen⁴, Elisabeth Ellingsen Husebye²

Affiliations

¹ Division of Orthopaedic Surgery, Oslo University Hospital, Norway; Institute of Clinical Medicine, University of Oslo, Norway. Electronic address: arhauk@ous-hf.no.
² Division of Orthopaedic Surgery, Oslo University Hospital, Norway.
³ Department of Radiology and Nuclear Medicine, Oslo University Hospital, Norway.
⁴ Division of Orthopaedic Surgery, Oslo University Hospital, Norway; Institute of Clinical Medicine, University of Oslo, Norway.

PMID: 33832813
DOI: 10.1016/j.fas.2021.03.017

Abstract

Background: The aim of this study was to evaluate the outcome after nondisplaced and stable Lisfranc injuries.

Methods: 26 patients with injuries to the Lisfranc joint complex detected on CT scans, but without displacement were tested to be stable using a fluoroscopic stress test. The patients were immobilized in a non-weightbearing short leg cast for 6 weeks. The final follow-up was 55 (IQR 53-60) months after injury.

Results: All the Lisfranc injuries were confirmed to be stable on follow-up weightbearing radiographs at a minimum of 3 months after injury. Median American Foot and Ankle Society (AOFAS) midfoot score at 1-year follow-up was 89 (IQR 84-97) and at final follow-up 100 (IQR 90-100); The AOFAS score continued to improve after 1-year (P=.005). The median visual analog scale (VAS) for pain was 0 (IQR 0-0) at the final follow-up. One patient had radiological signs of osteoarthritis at 1-year follow-up.

Conclusion: Stable Lisfranc injuries treated nonoperatively had an excellent outcome in this study with a median follow-up of 55 months. The AOFAS score continued to improve after 1 year.

Keywords: Lisfranc injury; Midfoot injury; Nonoperative; Stable; Tarsometatarsal joint injury.

MeSH terms

Foot Injuries* / surgery
Foot Injuries* / therapy
Fracture Fixation, Internal
Fractures, Bone* / surgery
Humans
Joint Dislocations* / surgery
Prospective Studies
Retrospective Studies
Treatment Outcome