Return to sport following Lisfranc injuries: A systematic review and meta-analysis. Issue 5 (October 2019)

• Record Type: Journal Article
• Authors: Robertson, Gregory Aidan James; Ang, Kok Kiong; Maffulli, Nicola; Keenan, Gary; Wood, Alexander MacDonald
• Is Part Of: Foot and ankle surgery. Volume 25:Issue 5(2019)
• Page Start: 654
• Page End: 664
• Publication Date: 2019-10
• Subjects: Lisfranc -- Tarso-metarsal -- Mid-foot -- Return -- Sport -- Rate -- Time; Foot -- Surgery -- Periodicals; Ankle -- Surgery -- Periodicals; Ankle -- surgery -- Periodicals; Foot -- surgery -- Periodicals; Ankle -- Surgery; Foot -- Surgery; Periodicals; Electronic journals; 617.58
• DOI: 10.1016/j.fas.2018.07.008
• Languages: English
• ISSNs: 1268-7731

Abstract

Highlights: Non-operative management of undisplaced (Stage 1) injuries provided good results (RR 100%, RT 4.0 weeks). Non-operative management of stable minimally-displaced (Stage 2) injuries provided good results (RR 100%, RT 9.1 weeks). PRIF showed significantly better RR (98% vs 78%) and RT (11.6 weeks vs 19.6 weeks) compared to ORIF. PRIF showed significantly better RR (98% vs 85%) and RT (11.6 weeks vs 22.0 weeks) compared to PPA. There was no significant difference between RR (78% vs 85%) and RT (19.6 weeks vs 22 weeks) for ORIF vs PPA. Abstract: Background: Information regarding return rates (RR) and mean return times (RT) to sport following Lisfranc injuries remains limited. Methods: A systematic search of nine major databases was performed to identify all studies which recorded RR or RT to sport following lisfranc injuries. Results: Seventeen studies were included (n = 366). For undisplaced (Stage 1) injuries managed nonoperatively (n = 35), RR was 100% and RT was 4.0 (0–15) wks. For stable minimally-displaced (Stage 2) injuries managed nonoperatively (n = 16), RR was 100% and RT was 9.1 (4–14) wks. For the operatively-managed injuries, Percutaneous Reduction Internal Fixation (PRIF) (n = 42), showed significantly better RR and RT compared to both: Open Reduction Internal Fixation (ORIF) (n = 139) (RR — 98% vs 78%, p < 0.019; RT — 11.6 wks vs 19.6 wks, p < 0.001); and Primary Partial Arthrodesis (PPA) (n = 85) (RR — 98% vs 85%, p < 0.047; RT — 11.6 wks vs 22.0 wks, p < 0.002). Conclusions: Stage 1 and stable Stage 2 Lisfranc injuries show good results with nonoperative management. PRIF offers the best RR and RT from the operative methods, though this may not be possible with high-energy injuries. Level of Evidence: IV. Systematic Review of Level I to Level IV Studies.