Evaluating plate fixation outcomes in the treatment of Lisfranc injuries

Background: Ligament injuries and fracture-dislocations, commonly known as Lisfranc injuries, can affect the tarsometatarsal (TMT) joints. These injuries may result in chronic pain and functional impairment due to several factors, including arthritis, deformity, lingering ligament instability, and damage to surrounding soft tissues. This study aimed to evaluate how effective plates and screws are in fixing Lisfranc injuries by examining both clinical and radiological outcomes. Methods: This prospective study included 20 adult patients with acute traumatic the foot Lisfranc injuries, in Shebin El-Kom Teaching Hospital All patients underwent clinical evaluation and radiological evaluation including pain x ray including anteroposterior, lateral and oblique views, Ct scan. Results: Only 4 patients have complications (one complicated by deep venous thrombosis, one by Saudex atrophy, one had superficial infection and broken screw and finally one had superficial wound infection and Saudex atrophy). Median American orthopedic foot and ankle society score (AOFAS) score was 79 and median foot and ankle outcome score (FAOS) was 78. There is significant moderate to good negative correlation between age and AOFAS&FAOS (P value 0.001&0.014 respectively). There is statistically substantial lower AOFAS score among smokers compared to non-smokers (P value 0.005). There is statistically significant lower FAOS score among smokers compared to non-smokers (P value 0.005). Conclusions: Dorsal plate / open reduction and internal fixation carry superior results as it allows anatomic reduction and spanning of comminution if present. Anatomical stable reduction is the main determinant for better results. Complications of missed or inadequately treated cases are significant and may threat athletes return to play.