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Nonunion Rate Following Primary Arthrodesis for Acute Lisfranc Injuries
Nathaniel A Ptak1, Ryan B Rigby2, Steven M Douthett3
1Kaiser - TSPMG, Sandy Springs, GA.
Summary
Primary arthrodesis (PA) for acute Lisfranc (TMT) injuries shows high fusion success rates. This surgical approach offers predictable outcomes with low nonunion rates, making it a viable option for midfoot instability.
Area of Science:
- Orthopedic surgery
- Foot and ankle reconstruction
- Trauma surgery
Background:
- Tarsometatarsal (TMT) joint injuries cause midfoot instability often unresponsive to conservative treatment.
- Surgical options for TMT instability include open reduction and internal fixation (ORIF) or primary arthrodesis (PA).
- Surgeons increasingly favor PA due to similar outcomes to ORIF and avoidance of hardware removal, though nonunion is a concern.
Purpose of the Study:
- To evaluate nonunion rates in patients undergoing primary arthrodesis for acute Lisfranc injuries.
- To assess the efficacy and predictability of PA in managing acute TMT joint instability.
Main Methods:
- Retrospective review of 34 patients with acute Lisfranc injuries treated with PA.
- Radiographic evaluation for nonunion at regular postoperative intervals.
- Analysis of fusion rates across the first, second, and third TMT joints.
Main Results:
- A total of 71 TMT joints were fused with an overall successful fusion rate of 95.8%.
- Average time to fusion was 7.9 weeks postoperatively.
- Individual nonunion rates were 0% for the first TMT, 1.4% for the second TMT, and 2.8% for the third TMT.
Conclusions:
- Primary arthrodesis is a predictable treatment for acute Lisfranc injuries.
- PA demonstrates low nonunion rates in the management of acute TMT joint instability.
- This study supports PA as an effective surgical option for acute Lisfranc injuries.
