Arthrodesis versus ORIF for Lisfranc fractures

The Lisfranc joints make up the bony structural support of the transverse arch in the midfoot and account for approximately 0.2% of all fractures. Early recognition and treatment of this injury are paramount to preserving normal foot biomechanics and function. Controversy exists regarding the optimal treatment of patients with Lisfranc injuries, particularly when the instability is entirely ligamentous.The authors performed a qualitative, systematic review of the literature to compare the 2 most common procedures for Lisfranc fractures: primary arthrodesis and open reduction and internal fixation (ORIF). Six articles with a total of 193 patients met the inclusion criteria. At 1-year follow-up, the mean American Orthopaedic Foot and Ankle Society score of ORIF patients was 72.5 and of arthrodesis patients was 88.0. Fisher's exact test revealed no significant effect of treatment group on the percentage on patients who had an anatomic reduction (P=.319).This study highlights that both procedures yield satisfactory and equivalent results. A slight advantage may exist in performing a primary arthrodesis for Lisfranc joint injuries in terms of clinical outcomes.