Best Practice Case Studies-Lisfranc Injuries

Pdf Summary

This systematic review and meta-analysis examines the management and outcomes of Lisfranc injuries, which affect the tarsometatarsal joint and are common among athletes. The study focuses on the return to sport following different treatment methods for these injuries. Data from 17 studies involving 366 injuries reveals varied outcomes based on the severity and treatment method.<br /><br />Key findings indicate that non-operative management shows good results for Stage 1 and stable Stage 2 Lisfranc injuries, with return rates (RR) up to 100% and shorter return times (RT). For operative treatments, Percutaneous Reduction Internal Fixation (PRIF) provides better return rates and times compared to Open Reduction Internal Fixation (ORIF) and Primary Partial Arthrodesis (PPA), especially in low-energy injury patterns. Specifically, PRIF yields an RR of 98% and an RT of 11.6 weeks, compared to ORIF with a 78% RR and 19.6 weeks RT. PPA outcomes also lag behind PRIF.<br /><br />The study emphasizes that while Lisfranc injuries are uncommon across the general population, their prevalence in sports such as American football is notable. The injuries can result from high-energy mechanisms like accidents or from lower-energy sports incidents.<br /><br />The review concludes that non-operative management is effective for undisplaced or minimally displaced injuries. However, operative management, particularly with PRIF, is recommended for displaced or unstable injuries, with no significant difference found between ORIF and PPA for higher-energy injuries.<br /><br />The analysis suggests that the choice of treatment should be guided by injury severity, and calls for better rehabilitation protocols and higher-quality research to optimize outcomes. Although the study provides comprehensive findings, it notes limitations such as variation in injury types and treatment approaches, suggesting a need for further studies to refine management strategies.

Meta Tag

Edition 2nd Edition

Related Case 2nd Edition, CASE 13

Topic Foot and Ankle

Keywords

2nd Edition, CASE 13

2nd Edition

Foot and Ankle

Lisfranc injuries

tarsometatarsal joint

return to sport

non-operative management

operative treatments

Percutaneous Reduction Internal Fixation

Open Reduction Internal Fixation

Primary Partial Arthrodesis

sports injuries

rehabilitation protocols