Abstract
IntroductionLisfranc injuries form a distinct group of rare but severe injury. Literature suggests a low incidence, but failure to diagnose these injuries early and its subsequent delay in management will affect the patient’s mobility and quality of life significantly. The preferred mode of management is said to be surgical. Conversely, the method of intervention for patients not suitable for surgery is less clear.AimThis study aims to evaluate the effect of delayed diagnosis and the treatment provided on the overall functional outcome for the patients with missed Lisfranc injury.MethodologyThe study was conducted at a specialist centre in the North-West of UK between January 2011 and November 2016. All patients with acute Lisfranc injuries were included in this study. Patient data was collected through electronic notes and analysed to ascertain missed diagnosis. It was also used to evaluate functional and radiological outcome.ResultsIn our series, 58.8% of Lisfranc injuries were missed on their initial presentation. We report better results for the surgical group when compared with the non-operated group, in spite of the delay in diagnosis.ConclusionWe believe that definitive treatment in the form of surgical fixation and anatomical reduction has more influence on the functional outcome than the timing of the surgical fixation in case of subtle Lisfranc injuries.
Highlights
Lisfranc injuries form a distinct group of rare but severe injury
The tarsometatarsal joint of the foot is named as Lisfranc joint, and its injury is named after French surgeon Jacques Lisfranc [1]
Lisfranc ligament is torn in pure ligamentous or in a fracture dislocation type of injury which leads to loss of alignment at tarsometatarsal joint [2]
Summary
Lisfranc injuries form a distinct group of rare but severe injury. Literature suggests a low incidence, but failure to diagnose these injuries early and its subsequent delay in management will affect the patient’s mobility and quality of life significantly. Aim This study aims to evaluate the effect of delayed diagnosis and the treatment provided on the overall functional outcome for the patients with missed Lisfranc injury. Many dorsal and plantar ligament provides stability to the Lisfranc joint, the most important structure is the plantar interosseous ligament which extends from the lateral surface of the medial cuneiform to the base of the second metatarsal. The incidence of Lisfranc injuries is around 1 in 55,000 per year [3] This number could be deceiving as approximately 20 to 24% of Lisfranc injuries are missed at their initial presentation [4].
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