Return to sport following Lisfranc injuries: A systematic review and meta-analysis

Abstract

BackgroundInformation regarding return rates (RR) and mean return times (RT) to sport following Lisfranc injuries remains limited. MethodsA systematic search of nine major databases was performed to identify all studies which recorded RR or RT to sport following lisfranc injuries. ResultsSeventeen 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). ConclusionsStage 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.