title: Early weight-bearing after percutaneous reduction and screw fixation for low-energy lisfranc injury.
abstract: BACKGROUND
  Anatomic restoration and postoperative rehabilitation of displaced fracture-dislocations of the tarsometatarsal junction of the foot are essential. Our objective was to report percutaneous reduction and screw fixation results in low-energy Lisfranc fracture dislocation injuries that were treated with early weight-bearing and rehabilitation.
  
  
  METHODS
  We retrospectively evaluated patients with low-energy Lisfranc injuries who underwent surgery between May 2007 and April 2011. The study reviewed 22 patients (12 men and 10 women) with an average age of 36.2 years (range, 16-50 years) and an average follow-up of 33.2 months (range, 12-50 months). We report the mechanism of trauma; quality of reduction in the postoperative digital radiographs; subjective satisfaction; AOFAS score; time required to return to work, recreational activities, and low-impact sports; and complications. Postoperatively, all of the patients were instructed to be non-weight-bearing for 3 weeks, and the stitches were removed after 2 weeks. At the third postoperative week, the patients were encouraged to bear weight as tolerated.
  
  
  RESULTS
  Quality of reduction was anatomic or near anatomic in 100% of cases. The subjective satisfaction reported by patients was very good, with complete satisfaction in 20 of them (90.9%). The AOFAS average was 94 points (range, 90-100 points). Average return to work was at 7 weeks (range, 6-9 weeks), recreational activities 7.2 weeks (range, 6-9 weeks), training for low-impact sports 7.6 weeks (range, 7-8 weeks), and symptom-free sport activities 12.4 weeks (range, 11-13 weeks).
  
  
  CONCLUSIONS
  In this selected group of patients with low-energy Lisfranc fracture dislocation, anatomic or near-anatomic reduction can be achieved with percutaneous reduction and screw fixation. Early weight-bearing is possible in these patients, and early return to regular activities and low-impact sport can be expected.
  
  
  METHODS
  Level IV, retrospective case series.
authors: Orthopaedic Surgery Department, Clínica Alemana de Santiago and Faculty of Medicine, Universidad del Desarrollo, Santiago, Chile.
authors: Emilio
authors: E
authors: Wagner
authors: Cristian
authors: C
authors: Ortiz
authors: Ignacio E
authors: IE
authors: Villalón
authors: Andrés
authors: A
authors: Keller
authors: Pablo
authors: P
authors: Wagner
mesh_terms: D000293:Adolescent; D000328:Adult; D001863:Bone Screws; D005260:Female; D005593:Fracture Fixation, Internal; D017102:Fracture Healing; D006801:Humans; D057072:Intra-Articular Fractures / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D004204:Joint Dislocations / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008682:Metatarsal Bones / Q000293:injuries; D008875:Middle Aged; D011859:Radiography; D020127:Recovery of Function; D013640:Tarsal Joints / Q000293:injuries*; D013997:Time Factors; D016896:Treatment Outcome; D016474:Weight-Bearing / Q000502:physiology*; D055815:Young Adult
keywords: Lisfranc fracture dislocation; fracture; percutaneous; reduction; rehabilitation