Lisfranc injury--surgical fixation facilities an early return to work.
BACKGROUND
Lisfranc injury is rare and the diagnosis maybe easily missed. This study reviews the experience of a single centre.


METHODS
A prospective review of patients with Lisfranc injuries presenting to a single surgeon with a specialist interest in foot and ankle surgery over a one year period.


RESULTS
Five patients were identified--four men and one woman with a median age of 31 years (range 22-50 years). Presentation was a mean of 25 days after injury (range 3-56 days). The left foot was affected in three cases and the right in two. There was joint diastasis in four patients and fracture-dislocation in one. Three patients presented early and were treated by internal fixation and two presented late and were managed conservatively. Mean follow-up was eight months (range 4.5-12 months). Surgery resulted in a return to work by 6 months with no symptoms. The two patients managed conservatively continued to experience pain at 12 months and were unable to return to their original occupations.


CONCLUSIONS
Injury to the Lisfranc joint should be excluded in any foot injury. Early diagnosis and internal fixation appears to result in an earlier return to work when compared to non-operative management.
Brinsden
M D
MD
Derriford Hospital , Plymouth
Smith
S R
SR
Loxdale
P H
PH
D000328:Adult; D005260:Female; D005593:Fracture Fixation, Internal / Q000379:methods* / Q000534:rehabilitation; D006801:Humans; D008297:Male; D008682:Metatarsal Bones / Q000293:injuries* / Q000601:surgery; D008875:Middle Aged; D011446:Prospective Studies; D013640:Tarsal Joints / Q000293:injuries* / Q000601:surgery