Open reduction and temporary rigid internal fixation of Lisfranc fracture-dislocations

To review the results of open reduction and temporary rigid screw fixation of Lisfranc fracture-dislocations performed in Singapore General Hospital (SGH) from 1996 to 1998.

A retrospective review of II cases of Lisfranc injuries treated with temporary rigid internal screw fixation with a minimum follow up of six months was carried out. Radiological assessment was made at follow up to ascertain the anatomical reduction achieved and complications such as post-traumatic arthritis. In addition, the patients were evaluated with a functional assessment with relation to pain, interference to usual activities and the time to resumption of work.

Anatomical reduction was achieved in all cases. None of the cases showed loss of reduction at follow up after the temporary implants were removed. No longitudinal arch collapse or other deformities were seen. All the patients had good or excellent functional outcomes.

Results of treatment of Lisfranc injuries are related to anatomical correction. Temporary screw fixation allows rigid internal fixation with stability to allow anatomical correction. Screws also maintain their stability longer, allowing ligamentous injuries the longer period necessary for healing. In conclusion, temporary rigid screw fixation of Lisfranc fracture maintains anatomical reduction and gives excellent functional outcomes for the patients.