Related risk factors for low-energy Lisfranc injury

Abstract

Objective To analyze the related risk factors for Lisfranc injury resulting from low energy violence. Methods A retrospective study was performed for 61 cases (35 males, 26 females) with low-energy foot injury hospitalized from June 2008 to June 2014. Mean age was 36.7 years (range, 16-57 years). Fall injuries were noted in24 cases, sports injuries in 21 cases, and twist injuries in 16 cases. The cases were divided into Lisfranc injury group(n=23) and non-Lisfranc injury group (n=38) according to the different diagnosis. Univariate analysis and multi-factor logistic regression analysis were used to identify the factors that may lead to the occurrence of Lisfranc injury including age, gender, body mass index, operation history, smoking, alcohol abuse, injury reason, medial depth of the mortise/ second metatarsal length(b/a), lateral depth of the mortise/ second metatarsal length(c/a), first metatarsal-to-talus angle, first intermetatarsal angle, second metatarsal length/ foot length(a/g), calcaneal inclination angle and cuboid-navicular overlap/cuboid vertical height(e/e+ f). Results Univariate analysis showed between-group differences were significant in age (χ2=7.385, P<0.05), injury reason (χ2=8.663, P<0.05), calcaneal inclination angle(t=3.958, P<0.05), b/a (t=5.051, P<0.05) and a/g(t=4.618, P<0.05). Logistic regression analysis identifiedb/a(OR=1.036, 95%CI 0.018-0.450, P<0.01) and a/g(OR=1.013, 95%CI 0.005-0.374, P<0.01) as independent risk factors for low-energy Lisfranc injury. Conclusion Low-energy Lisfranc injury is independently associated with b/a and a/g, and may relate to the decreased medial depth of the mortise and increased foot length. Key words: Foot injuries; Risk factors; Lisfranc injury