Staged surgery for closed Lisfranc injury with dislocation

Area of Science:

• Orthopedic Surgery
• Trauma Care
• Foot and Ankle Surgery

Background:

• Lisfranc injuries are complex foot traumas requiring effective surgical management.
• Optimal timing and technique for surgical intervention in closed Lisfranc injuries with dislocation remain debated.
• Perioperative complications and functional outcomes are key considerations in treating these injuries.

Purpose of the Study:

• To evaluate the clinical efficacy of staged surgery versus single-stage surgery for closed Lisfranc injury with dislocation.
• To compare functional outcomes, complication rates, and resource utilization between the two surgical approaches.

Main Methods:

• Retrospective study of 48 patients with acute closed Lisfranc injury and dislocation.
• Group A: Staged surgery (emergency reduction followed by open reduction and internal fixation/fusion).
• Group B: Single-stage surgery (elective open reduction and internal fixation).
• Assessment using American Orthopedic Foot and Ankle Society (AOFAS) and Visual Analog Scale (VAS) scores.

Main Results:

• Staged surgery group (A) showed significantly better AOFAS (86.87 vs 71.72) and VAS (1.91 vs 3.20) scores at 1-year follow-up.
• Group A had shorter hospitalization (11.52 vs 19.80 days) and surgery durations (67.34 vs 104.36 min).
• Lower incidence of complications observed in the staged surgery group, with only 2 cases of traumatic arthritis in Group B.

Conclusions:

• Staged surgery for closed Lisfranc injury with dislocation leads to superior clinical outcomes.
• This approach effectively reduces perioperative complications and resource utilization.
• Staged surgery is a favorable treatment option for Lisfranc injuries with dislocation.