Outcomes of Lisfranc Injuries in NCAA Football Players

Abstract

Category: Sports; Midfoot/Forefoot Introduction/Purpose: While Lisfranc injuries are relatively infrequent, they are typically season-ending injuries for NCAA football players, and their impact on an athlete's future is poorly understood. In this study, we sought to define the rate of return to competition for NCAA Division I football players who sustained a Lisfranc injury, and analyze the effects on athletic performance and career outcomes. Methods: NCAA Division I football players who sustained Lisfranc injuries between 2012-2017 were identified and evaluated for their return to play in the season following their injury. Recorded demographic variables included position, class rank, and games played during the pre- and post-injury seasons. The underclassmen athletes who met performance criteria were then compared to matched, uninjured controls based on conference, position, age, and statistics. Career outcomes were evaluated for all athletes who sustained a Lisfranc injury based on whether they performed at the NFL Combine and/or played in at least 1 NFL game. Seniors were excluded from performance analysis because they did not have a post-injury NCAA season, but were included in career outcomes. Results: Sixty Lisfranc injuries were identified, 48 of which were sustained by underclassmen, who returned to play in the immediate post-injury season at a rate of 87.5%, and 95.8% returned at some point in their college careers. Of the players who met performance criteria, only quarterbacks showed statistically significant differences compared to controls for interceptions/game (p=0.0438), yet all positions experienced mild performance declines or stagnation across virtually all statistics, on average. However, 33.3% of athletes went on to perform at the NFL Combine, and 31.3% of athletes played in an NFL game, compared to 31.7% and 36.7%, respectively, for controls. Surprisingly, when evaluated separately, athletes who sustained a Lisfranc injury in their senior year had nearly identical career outcomes (Combine - 33.3%, NFL - 33.3%) compared to underclassmen. Conclusion: NCAA Division I football players return to play at a high rate following Lisfranc injuries, and largely maintain their athletic performance relative to uninjured controls. Moreover, Lisfranc injuries do not appear to have a significant impact on an athlete's ability to compete at an NFL-level.