Lisfranc Fixation Utilizing Dorsomedial Plating Technique

Abstract

Ideal treatment for Lisfranc injuries is often debated, but ultimately the 2 main pillars of surgical intervention consist of open reduction and internal fixation versus arthrodesis. When adhering to the principles of rigid fixation and anatomic reduction, both interventions yield similar results and patient satisfaction. The purpose of this article and associated video is to simplify operative intervention of this complex injury pattern into a reliable biomechanically stable plating technique using a dorsomedial approach that results in good patient outcomes and is largely joint sparing. The cohort used for this technique guide consists of 31 patients with at least 12-month follow-up. Notable results include mean operative room time of 81 minutes, median time to union 198 days, and 1 non-union. Complications included 4 superficial infections and 1 deep infection, 7 patients with broken hardware, 1 non-union, and 15 patients elected to have hardware removed although not necessary for this technique.Level of Evidence: Therapeutic Level IV: Case Series.

Keywords: Lisfranc; ORIF; TMT plating; dorsomedial approach; high energy trauma; midfoot injury.