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. 2023 Mar 20;8(1):24730114231160762.
doi: 10.1177/24730114231160762. eCollection 2023 Jan.

Patient-Reported Outcome Measures After Surgical Management of Unstable Lisfranc Injuries in Athletes

Cortez L Brown  1 , Nia A James  1 , Chukwudi Onyeukwu  1 , Rebekah Belayneh  1 , Lorraine Boakye  1 , MaCalus V Hogan  1
Affiliations

Patient-Reported Outcome Measures After Surgical Management of Unstable Lisfranc Injuries in Athletes

Cortez L Brown et al. Foot Ankle Orthop. .

Abstract

Background: Athletes sustaining Lisfranc joint instability after a low-energy injury often undergo surgical fixation. Limited studies report validated patient-reported outcome measures (PROMs) for this specific patient population. Our purpose was to report PROMs of athletes experiencing instability after a low-energy Lisfranc injury and undergoing surgical fixation.

Methods: Twenty-nine athletes (23 competitive, 6 recreational) sustained an unstable Lisfranc injury (14 acute, 15 chronic) and met our inclusion criteria. Injuries were classified as acute if surgically managed within 6 weeks. All athletes completed validated PROMs pre- and postoperatively. The cohort underwent various open reduction internal fixation methods. We evaluated outcomes with the Foot and Ankle Ability Measure (FAAM) activities of daily living (ADL) and sports subscales.

Results: Fourteen of 29 (48%) athletes reported PROMs at ≥2 years with a median follow-up time of 44.5 months. Substantial improvement for both FAAM ADL (50% vs 93%; P < .001) and sports (14.1% vs 80%; P = .002) subscales were found, when comparing preoperative to postoperative scores at ≥2 years.

Conclusion: This study provides outcomes information for the young athletic population that were treated operatively for low-energy Lisfranc injury with apparent joint instability. Based on the FAAM sports subscale, these patients on average improved between their 6-month evaluation and their final ≥2 years but still scored 80% of the possible 100%, which indicates continued but "slight" difficulty with lower extremity function.

Level of evidence: Level IV, case series.

Keywords: Lisfranc; midfoot; outcome studies; sports.

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Conflict of interest statement

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article. ICMJE forms for all authors are available online.

Figures

Figure 1.
Figure 1.
Patient selection flow chart. *Due to patient not completing a questionnaire during a visit for an unspecified reason.
Figure 2.
Figure 2.
Fixation devices used to anatomically reduce Lisfranc joint: (A) Dorsal locking plate with both a Lisfranc and intercuneiform screw. (B) Isolated suture-button. (C) Isolated Lisfranc and intercuneiform screws.
Figure 3.
Figure 3.
Pre- and postoperative images of a 19-year-old male patient who sustained an unstable right Lisfranc injury at practice. He underwent open reduction and internal fixation with dorsal bridge plate and transarticular screws. (A) Diastasis between the medial cuneiform and the base of the second metatarsal. (B) Complete disruption of the Lisfranc ligament between medial cuneiform and second metatarsal. (C) Postreduction films.
See this image and copyright information in PMC

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