title: Randomized, Prospective Comparison of Bioabsorbable and Steel Screw Fixation of Lisfranc Injuries.
abstract: OBJECTIVE
  This study's objective is to compare outcomes of bioabsorbable versus steel screws for treating Lisfranc injuries.
  
  
  METHODS
  This research was conducted in a prospective and randomized manner between September 2008 and December 2013.
  
  
  METHODS
  This study was performed in the outpatient setting at a tertiary-level care center in a single surgeon's practice.
  
  
  METHODS
  Forty patients with acute Lisfranc injuries, amenable to open reduction and screw fixation, enrolled and presented for final follow-up.
  
  
  METHODS
  Through randomization, 20 and 20 patients received bioabsorbable versus steel screws, respectively.
  
  
  METHODS
  Function and pain were graded using the Foot and Ankle Ability Measures (FAAM) and a visual analog scale of pain. Radiographs were assessed for joint stability and degeneration.
  
  
  RESULTS
  For those with steel screws, the mean FAAM score increased from 24.9 to 89.6 of 100 and pain score decreased from 6.5 to 1.9 of 10 by latest follow-up. For those with absorbable screws, the mean FAAM score increased from 32.5 to 91.2 and pain score decreased from 4.7 to 1.3 by latest follow-up. These differences in final mean function (P = 0.4) and pain (P = 0.25) between the study groups were not statistically significant. Final radiographs showed no Lisfranc instability in any study patients, but rather midfoot arthritis in 4 and 2 patients with steel versus bioabsorbable screws, respectively. None of the patients who received steel screws had hardware-related problems, but 1 patient who received absorbable fixation developed an inflammatory reaction at a nonresorbed screw head at 2 years after surgery.
  
  
  CONCLUSIONS
  Bioabsorbable screws provide short-term results that are comparable and not significantly different from steel screws for treating unstable Lisfranc injuries. Both methods are predictable in improving function and pain, but using absorbable screws eliminates the need for hardware removal after such trauma.
  
  
  METHODS
  Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.
authors: *Department of Orthopaedic Surgery, Rothman Institute Orthopaedics at Thomas Jefferson University Hospital, Philadelphia, PA; and †Rothman Institute Orthopaedics at Thomas Jefferson University Hospital, Philadelphia, PA.
authors: Jamal
authors: J
authors: Ahmad
authors: Kennis
authors: K
authors: Jones
mesh_terms: D020341:Absorbable Implants; D000293:Adolescent; D000328:Adult; D001863:Bone Screws; D005260:Female; D018409:Foot Injuries / Q000175:diagnosis / Q000601:surgery*; D005593:Fracture Fixation, Internal / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods; D006801:Humans; D004204:Joint Dislocations / Q000175:diagnosis / Q000601:surgery*; D007593:Joint Instability / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control*; D011446:Prospective Studies; D013193:Stainless Steel; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D013193:Stainless Steel