Functional Outcome of Internal Fixation of Lisfranc Fractures

Abstract

Background: The occurrence of Lisfranc fractures in our population is increasing with rise in road traffic accidents despite being a rare fracture to see. Diagnosis of these fractures is always a challenge to the treating orthopedician. Few studies have only been done in India on such fractures and that explains the need for research in treating these fractures. Materials and Methods: This prospective observational study reports the functional outcome of 20 patients operated with internal fixation. 20 patients with Lisfranc fracture fitting for the inclusion criteria who came to Orthopaedic Department of Thrissur medical college between 1/1/2016 and 1/1/2017 were surgically treated with open reduction and internal fixation with transarticular screws. Partial weight bearing was started only after the onset of radiological union. They were followed up clinically and radiologically for six months. Functional outcome was assessed after 6 months using American Orthopaedic Foot and Ankle Society (AOFAS) score. Results & Discussion: In our study the mean age of males was 29.7 (n=9) and females was 40.2 (n=11). Equal distribution of cases in case of high energy and low energy injury was seen. Right foot was found to be involved in 60% of cases. Four cases had associated tendon injury and another eight cases had suffered other fractures of foot. Diabetes and hypertension were associated in 4 cases. Five patients had developed significant osteoarthritis following surgery. Average stay in hospital was 17 days. Average AOFAS score was 80.4. Excellent results were obtained for 4 cases (20%) and good results for 11 cases (55%). Conclusion: Internal fixation is a good method for reducing and fixing Lisfranc fractures early to improve functional results. Early mobilization and proper follow up are also necessary for good functional outcome.