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Outcome after nonoperative treatment of stable Lisfranc injuries. A prospective cohort study
Are H Stødle1, Kjetil H Hvaal2, Helga Brøgger3
1Division of Orthopaedic Surgery, Oslo University Hospital, Norway; Institute of Clinical Medicine, University of Oslo, Norway.
Background:
The aim of this study was to evaluate the outcome after nondisplaced and stable Lisfranc injuries.
Methods:
26 patients with injuries to the Lisfranc joint complex detected on CT scans, but without displacement were tested to be stable using a fluoroscopic stress test. The patients were immobilized in a non-weightbearing short leg cast for 6 weeks. The final follow-up was 55 (IQR 53-60) months after injury.
Results:
All the Lisfranc injuries were confirmed to be stable on follow-up weightbearing radiographs at a minimum of 3 months after injury. Median American Foot and Ankle Society (AOFAS) midfoot score at 1-year follow-up was 89 (IQR 84-97) and at final follow-up 100 (IQR 90-100); The AOFAS score continued to improve after 1-year (P=.005). The median visual analog scale (VAS) for pain was 0 (IQR 0-0) at the final follow-up. One patient had radiological signs of osteoarthritis at 1-year follow-up.
Conclusion:
Stable Lisfranc injuries treated nonoperatively had an excellent outcome in this study with a median follow-up of 55 months. The AOFAS score continued to improve after 1 year.
