[Selective tarsometatarsal arthrodesis for old Lisfranc injury]

Objective: To discuss the methods and clinical outcomes of selective tarsometatarsal (TMT) arthrodesis for old Lisfranc injury. Methods: The clinical data of 36 cases with old Lisfranc injury treated by selective arthrodesis from January 2010 to October 2016 in the Department of Orthopedics in Shanghai Sixth People's Hospital were analyzed retrospectively. There were 16 males and 20 females in this group with a mean age of (40±6) years. The information of pre-operative and post-operative X-ray, American Orthopaedics Foot and Ankle Society (AOFAS) midfoot score and pain Visual Analogue Scale (VAS) score was collected. The complications were also recorded. The pre- and post-operative data were compared with t test. Results: The 36 patients got a follow-up for at-least 2 years (averaged (4.3±1.6) years, ranged from 2 to 8 years). The post-operative AOFAS midfoot score was improved from (44±7)(28-60) to (83±7)(76-97)(t=-37.1, P<0.05), and the VAS score decreased from (6.3±2.5)(5-9) to (1.6±1.3)(0-3)(t=23.7, P<0.05). Implant breakage occurred in two patients and the symptom was relieved after the removal of implants. Conclusion: The selective TMT arthrodesis for old Lisfranc injury may relieve the symptoms, improve the function and life quality of patients by restoring the medial arch and midfoot and forefoot alignment.