Open Reduction Internal Fixation vs Primary Arthrodesis for Displaced Lisfranc Injuries: A Multicenter Randomized...

Area of Science:

• Orthopedic surgery
• Traumatology
• Foot and ankle surgery

Background:

• Lisfranc injuries lack consensus on optimal initial surgical management.
• Open reduction and internal fixation (ORIF) and primary arthrodesis (PA) are primary surgical options.
• Displaced Lisfranc injuries require careful consideration for surgical approach.

Purpose of the Study:

• To compare the efficacy of ORIF versus PA for treating displaced Lisfranc injuries.
• To evaluate patient-reported outcomes following surgical intervention for Lisfranc injuries.

Main Methods:

• A national multicenter randomized controlled trial involving 43 patients with displaced Lisfranc injuries.
• Primary outcome: Visual Analogue Scale Foot and Ankle (VAS-FA) at 24 months.
• Secondary outcomes: VAS-FA subscales and American Orthopaedic Foot & Ankle Society (AOFAS) Midfoot Scale at 6, 12, and 24 months.

Main Results:

• Mean VAS-FA Overall scores at 24 months were 86.5 for ORIF and 80.1 for PA.
• No statistically significant difference in VAS-FA Overall scores between the ORIF and PA groups (mean difference 6.5, 95% CI -5.3 to 18.2).
• The study was underpowered due to a lower-than-planned sample size.

Conclusions:

• Both ORIF and PA are viable initial surgical options for displaced Lisfranc injuries.
• No significant difference in patient-reported outcomes was found between the two surgical methods at 24 months.
• Findings suggest that the choice between ORIF and PA may depend on other factors, and data can contribute to future meta-analyses.