Factors Influencing PROMIS Scores and Patient Reported Outcomes Following Surgical Intervention of Isolated Lisfranc Injury: Minimum 2 Year Follow-up

J Foot Ankle Surg. 2024 May-Jun;63(3):359-365. doi: 10.1053/j.jfas.2024.01.005. Epub 2024 Jan 20.

Abstract

Lisfranc injuries are rare but significant foot injuries, as they often result from polytrauma patients, and are often misdiagnosed, which further complicate their evaluation and contribute to their propensity towards disability. It is recommended that, on diagnosis, Lisfranc injuries be treated as soon as possible to decrease the risk of future chronic pain, disability, or osteoarthritis. Our study evaluated patients who completed the patient reported outcome measurement information systems (PROMIS) along with the foot function index (FFI) following operative fixation for Lisfranc injury. Fifty-one patients between 2010 and 2020 met inclusion criteria and were selected for this study, with completion. Utilizing the electronic medical record (EMR), patient charts were reviewed to obtain basic patient demographic information and comorbidities. Operative reports were reviewed to determine which procedure was performed for definitive fixation. Primary arthrodesis was associated with a significant decrease in complication rates (p = .025) when compared to ORIF. Females, arthrodesis, and procedures using a home run (HR) screw were independent risk factors for significantly higher reports of PROMIS pain interference. Arthrodesis also was associated with lower PROMIS pain interference scores. Arthrodesis and males exhibited higher scores in all FFI categories. Our results provide evidence that patient reported outcomes following Lisfranc surgery reported via PROMIS, FFI and VAS scores are independently influenced by patient demographics, comorbidities, and surgical variables. Analysis of potential associations between these patient characteristics and PROMIS and FFI scores provides evidence for physicians to manage patient expectations prior to operative treatment of a nonpolytraumatic Lisfranc injury.

Keywords: Lisfranc injury; Lisfranc ligament; Operative fixation; PROMIS; Patient reported outcomes.

MeSH terms

  • Adult
  • Aged
  • Arthrodesis*
  • Female
  • Follow-Up Studies
  • Foot Injuries* / surgery
  • Fracture Fixation, Internal / methods
  • Humans
  • Male
  • Metatarsal Bones / injuries
  • Metatarsal Bones / surgery
  • Middle Aged
  • Patient Reported Outcome Measures*
  • Retrospective Studies
  • Young Adult