Bridging fixation for Lisfranc injury

Abstract

Objective To report the outcomes of Lisfranc injury treated with bridging plating or external fixation.Methods From August 2008 to February 2011,26 cases of Lisfranc injury were treated with bridging plating or external fixation in our department.After diagnosis was confirmed by X-ray examination or/and CT scanning,open reduction and internal fixation was performed with a bridging plate or external fixator.Regular X-ray follow-ups were carried out to evaluate functional recovery by the American Orthopedic Foot and Ankle Society (AOFAS) midfoot score.The AOFAS scores 6 months and 18 months after operation were compared.Results This series got an average follow-up of 27 months,ranging from 18 to 49 months.The AOFAS midfoot score 6 months after operation was 59.6 ± 15.4 points,significantly lower than that 18 months after operation (76.8 ± 11.5 points) (t =12.620,P =0.000).Secondary post-traumatic arthritis occurred in 12 cases,2 of which had secondary arthrodesis as a result of severe pain.There was no internal fixation breakage.Conclusions For cases of low energy Lisfranc injury,bridging plating can reduce secondary injury to the articular cartilage.For cases of high energy Lisfranc injury,bridging external fixation can lead to reliable fixation and anatomical reduction to restore the shortened column height. Key words: Foot injuries; Bone plates; External fixators; Fracture fixation