Can early treatment of lisfranc injuries without planned re-intervention be safely performed

The Lisfranc complex is a unique combination of ligamentous and osseous relationships between the medial cuneiform and second metatarsal base that is often injured by high energy mechanisms. Fixation for these injuries is often operative; however, the optimal timing of surgical treatment has been de...

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Bibliographic Details
Published in:	The Journal of foot and ankle surgery
Main Authors:	DeGenova, Daniel T., Iandoli, James L., Melaragno, Anthony J., Hyland, Scott S., Dickinson, Sara E., Hoffman, Brett, Taylor, Benjamin C.
Format:	Journal Article
Language:	English
Published:	United States Elsevier Inc 09-10-2024
Subjects:	High-energy foot injury Lisfranc Lisfranc arthrodesis Lisfranc early treatment Midfoot trauma ORIF Lisfranc ORIF midfoot Midfoot trauma Lisfranc ORIF Lisfranc ORIF midfoot High-energy foot injury Lisfranc early treatment Lisfranc arthrodesis high-energy foot injury midfoot trauma
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Summary:	The Lisfranc complex is a unique combination of ligamentous and osseous relationships between the medial cuneiform and second metatarsal base that is often injured by high energy mechanisms. Fixation for these injuries is often operative; however, the optimal timing of surgical treatment has been debated. All patients who underwent operative fixation of a Lisfranc injury at a single urban tertiary care center were reviewed. Patient were split into two groups based on timing to fixation with one group being less than 24 h from presentation and a second group being greater than 24 h. There were 58 patients who underwent what was planned as final operative stabilization of their Lisfranc injury in less than 24 h and 41 patients who underwent fixation after more than 24 h. The early treatment of Lisfranc injuries did not lead to significant increases in follow up time, infections, time to weight bearing, union rates, or time to union compared patients treated with delayed fixation. There was a higher rate of superficial infection in the early intervention group, but it did not reach statistical significance. We believe our findings demonstrate that delayed fixation is not superior to early treatment of Lisfranc injuries. Level 3 Therapeutic retrospective comparative study.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	1067-2516 1542-2224 1542-2224
DOI:	10.1053/j.jfas.2024.09.015