Comparison of flexible fixation and screw fixation for isolated Lisfranc ligament injuries: A protocol for a meta-analysis of comparative studies

Medicine (Baltimore). 2022 Oct 21;101(42):e31233. doi: 10.1097/MD.0000000000031233.

Abstract

Background: The frequency of isolated Lisfranc ligament (ILL) injuries has been increasing recently with the increase in low-energy trauma resulting from sports injuries. For ILL injuries, the optimal method of fixation still remains controversial. The traditional fixation method is achieved by trans-articular screws, but recently, dorsal bridge plates and suture button (SB) fixation have become alternatives. Some biomechanical studies have showed that SB fixation can provide adequate strength compared to trans-articular screws. Therefore, a meta-analysis is imperative to provide evidence on whether flexible fixation is comparable to screw fixation for treatment of ILL injuries.

Methods: We will conduct a comprehensive literature search in PubMed, Cochrane Library, EMBASE and Web of Science databases and for comparative studies. We will apply the risk-of-bias tool of the Cochrane Collaboration for Randomized Controlled Trials to assess the methodological quality. Risk-of-Bias Assessment Tool for Non-randomized Studies was used to evaluate the quality of comparative studies. Statistical analysis will be conducted using RevMan 5.4 software (Cochrane Collaboration, London, England).

Results: This systematic review will evaluate the functional outcomes and radiographic results of flexible fixation for treatment of ILL injuries.

Conclusion: The conclusion of this study will provide evidence for judging whether flexible fixation is superior to screw fixation for treatment of ILL injuries.

MeSH terms

  • Bone Screws*
  • Foot / surgery
  • Fracture Fixation, Internal / methods
  • Humans
  • Ligaments, Articular* / injuries
  • Ligaments, Articular* / surgery
  • Meta-Analysis as Topic
  • Suture Techniques
  • Systematic Reviews as Topic