Lisfranc Fixation Techniques and Postoperative Functional Outcomes: A Systematic Review

Area of Science:

• Orthopedic Surgery
• Traumatology
• Biomechanics

Background:

• Acute Lisfranc injuries are complex midfoot trauma.
• Optimal surgical fixation methods are debated.
• Evidence comparing fixation techniques is limited.

Purpose of the Study:

• To systematically review literature on fixation methods for acute Lisfranc injuries.
• To evaluate the impact of fixation on postoperative functional outcomes.
• To compare bridge plate versus transarticular screw fixation.

Main Methods:

• Systematic review following PRISMA guidelines.
• Inclusion of studies reporting functional outcomes after open-reduction internal fixation.
• Meta-analysis of studies comparing bridge plate and transarticular screw fixation using a random-effects model.

Main Results:

• Seventeen studies with 462 patients were analyzed.
• Overall mean American Academy of Orthopaedic Surgeons midfoot score (AOFAS-MF) was 76.3.
• Bridge plate fixation showed a trend towards higher AOFAS-MF (79.2) compared to transarticular screws (74.2), with statistical significance in meta-analysis (p=0.006).

Conclusions:

• There is a scarcity of high-quality evidence on fixation methods for acute Lisfranc injuries.
• Bridge plate fixation may lead to superior functional outcomes.
• Further research is required to establish optimal fixation strategies for different injury patterns.