title: Temporary Internal Fixation for Ligamentous and Osseous Lisfranc Injuries: Outcome and Technical Tip.
abstract: BACKGROUND
  Open rather than closed reduction and internal fixation as well as primary definitive arthrodesis are well accepted for ligamentous and osseous Lisfranc injuries. For ligamentous injuries, a better outcome after primary definitive partial arthrodesis has been published.
  
  
  METHODS
  Of 135 Lisfranc injuries that were treated from 1998 to 2012 with open reduction, temporary internal fixation by screws and plates, and restricted weight bearing in a lower leg cast for 3 months followed by an arch support for another 4 to 6 weeks, 29 ligamentous Lisfranc injuries were available for follow-up. They were compared with 29 osseous Lisfranc injuries matched in age and gender.
  
  
  RESULTS
  Between the groups, there were no significant differences in average age (39.9 vs 38 years) or in average follow-up time (8.3 vs 9.1 years). Also, no significant differences were seen in the AOFAS midfoot score (84 vs 85.3 points), the FFI pain scale (9.9 vs 14.9 points), SF 36 physical component (56.2 vs 53.9 points), SF 36 mental component (57 vs 56.4 points), or VAS for pain (1.6 vs 1.5 points). The FFI function scale was significantly lower in the ligamentous group (11.6 vs 19.5 points). Radiographically, loss of reduction was recorded 3 times in the ligamentous injuries and 4 times in the osseous injuries. Arthritis was mild/moderate/severe in 5/3/0 ligamentous injuries and in 7/2/1 osseous injuries, requiring 1 definitive secondary Lisfranc arthrodesis in each group.
  
  
  CONCLUSIONS
  With longer and conservative postoperative management, open reduction and temporary internal fixation in ligamentous and osseous Lisfranc injuries led to equal medium-term outcome. Inferior outcome in ligamentous injuries was not found.
  
  
  METHODS
  Level III, retrospective comparative cohort study.
authors.affiliation: Inselspital, Orthopaedic Surgery, Berne, Switzerland.
authors.forename: Mohammad Reza
authors.initials: MR
authors.lastname: Abbasian
authors.affiliation: Inselspital, Orthopaedic Surgery, Berne, Switzerland.
authors.forename: Felix
authors.initials: F
authors.lastname: Paradies
authors.affiliation: Zieglerspital, Orthopaedic surgery, Bern, Switzerland.
authors.forename: Martin
authors.initials: M
authors.lastname: Weber
authors.affiliation: Inselspital, Orthopaedic Surgery, Berne, Switzerland fabian.krause@insel.ch.
authors.forename: Fabian
authors.initials: F
authors.lastname: Krause
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal; D050723:Fractures, Bone / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D004204:Joint Dislocations / Q000000981:diagnostic imaging / Q000601:surgery*; D008022:Ligaments / Q000293:injuries / Q000601:surgery*; D008297:Male; D008682:Metatarsal Bones / Q000000981:diagnostic imaging / Q000293:injuries / Q000601:surgery; D008875:Middle Aged; D063868:Patient Outcome Assessment; D011859:Radiography; D012189:Retrospective Studies; D000068958:Return to Sport; D013639:Tarsal Bones / Q000000981:diagnostic imaging / Q000293:injuries / Q000601:surgery; D013640:Tarsal Joints / Q000000981:diagnostic imaging / Q000293:injuries / Q000601:surgery*; D055815:Young Adult
keywords: Lisfranc injury; internal fixation; ligamentous; osseous