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Defining Operative Indications in Lisfranc Injuries: A Systematic Review
Christian Pearsall1, Emily Arciero1, Puneet Gupta1
1Department of Orthopedic Surgery, Columbia University Irving Medical Center, New York, New York.
Foot & Ankle Specialist
|June 6, 2023
Summary
Operative indications for Lisfranc injuries are inconsistently reported, often varying by diastasis measurements. Clearer, standardized reporting is crucial for effective clinical management of these subtle injuries.
Area of Science:
- Orthopedic Surgery
- Sports Medicine
- Trauma Surgery
Background:
- Lisfranc injuries, involving the midfoot, often require surgical intervention.
- Determining precise operative indications for Lisfranc injuries can be challenging due to varied injury presentations.
- Standardized criteria are needed to guide surgical decision-making in Lisfranc injuries.
Purpose of the Study:
- To systematically review and determine the operative indications for Lisfranc injuries reported in the literature.
- To identify common criteria and variations in reporting operative indications for Lisfranc injuries.
Main Methods:
- A systematic literature review was conducted using MEDLINE, searching for "Lisfranc Injury" from 1980 onwards.
- Studies were included if they reported explicit operative indications for Lisfranc injuries.
- Articles were excluded if they were non-English, inaccessible, irrelevant, or lacked specific operative indications.
Main Results:
- Fifty-eight reports provided explicit operative indications, with 81.1% specifying diastasis cutoffs (commonly ≥2 mm).
- Diastasis location was frequently unspecified (53.5%).
- Other criteria included avulsion fractures, arch height loss, MRI tears, and classification systems (Nunley and Vertullo, Myerson, Buehren).
Conclusions:
- Common operative indications for Lisfranc injuries involve diastasis measurements of 1-3 mm.
- Significant heterogeneity exists in reported operative indications, complicating clinical management.
- Increased frequency and standardization of reporting operative indications are essential for guiding treatment of Lisfranc injuries.
