A novel flexible fixation technique for Lisfranc injuries: clinical outcomes and radiographic follow-up

Abstract

Objectives: The purpose of this investigation is to present the follow-up results and patient-reported outcome measures (PROMs) of a continuous series of surgically managed Lisfranc injuries whose constructs included a novel technique. Methods: Our billing database was retrospectively queried by Current Procedural Terminology (CPT) codes to identify all Lisfranc injuries managed operatively between 2018 and 2021. Basic demographic data were collected. Clinical notes and radiographs were reviewed. Patients were contacted prospectively to complete the Foot and Ankle Ability Measurement – Activities of Daily Living (FAAM-ADL), Patient-Reported Outcomes Measurement Information System (PROMIS) Pain Intensity, PROMIS Pain Interference, and PROMIS Depression surveys. Descriptive statistics were calculated. Results: Sixteen patients were included. While all patients underwent flexible fixation (FF), nine of them underwent concomitant open reduction internal fixation (ORIF) and seven, concomitant primary arthrodesis. Median radiographic and PROMs follow-up time was 7.3 months (IQR 4.4–11.6) and 25.8 (IQR 9.5–32.4), respectively. All fusion patients had evidence of joint fusion, and 8/9 of ORIF patients maintained articular congruity without evidence of arthritis at final follow-up. Median PROMs were 85 (64.75–93.5), 53.1 (49.7–57.75), 45.7 (37.7–51.3), and 46 (43.3–52.28) for the FAAM-ADL, PROMIS Pain Interference, PROMIS Pain Intensity, and PROMIS Depression scores, respectively. Conclusion: The novel FF technique proposed for residual tarsometatarsal subluxation in Lisfranc injuries appears to be safe and effective, with good PROMs at two-year follow-up and low complication rates, obviating the need for hardware removal. Level of Evidence IV; Therapeutics Studies; Cases Series.