A Comparative Analysis of Suture-Button and InternalBrace Fixation for Purely Ligamentous Lisfranc Injuries

Area of Science:

• Orthopedic Surgery
• Foot and Ankle Reconstruction
• Trauma Surgery

Background:

• Purely ligamentous Lisfranc injuries present complex management challenges.
• Traditional rigid fixation methods risk cartilage damage and hardware issues.
• Flexible fixation systems like suture-button (SB) and InternalBrace (IB) aim for stability with physiological motion.

Purpose of the Study:

• To compare the clinical and radiographic outcomes of SB versus IB fixation for purely ligamentous Lisfranc injuries.
• To evaluate functional scores, pain levels, and radiographic alignment between the two fixation methods.

Main Methods:

• Retrospective comparative study of 64 patients with acute, purely ligamentous Lisfranc injuries.
• Follow-up duration of at least 24 months.
• Primary outcomes: American Orthopaedic Foot & Ankle Society (AOFAS) midfoot and visual analog scale (VAS) pain scores; radiographic outcome: C1-M2 interval maintenance.

Main Results:

• Both SB and IB groups showed significant improvements in AOFAS and VAS scores post-operatively.
• No significant differences were observed between SB and IB groups in final AOFAS scores (92.4 vs 91.5) or VAS scores (1.5 vs 1.2).
• Both techniques maintained anatomic reduction effectively, with no significant difference in C1-M2 diastasis or loss of reduction.

Conclusions:

• Suture-button (SB) and InternalBrace (IB) fixation yield excellent functional and radiographic results for purely ligamentous Lisfranc injuries.
• These flexible fixation methods offer reliable alternatives to rigid fixation with low complication rates.
• Both SB and IB systems provide stable and effective treatment options for this challenging injury pattern.