Management of Lisfranc Injuries: A Critical Analysis Review : JBJS Reviews

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Management of Lisfranc Injuries

A Critical Analysis Review

Carter, Thomas H. MD, FRCSEd(Tr&Orth); Heinz, Nicholas MMedSci, MRCSEd; Duckworth, Andrew D. MSc, PhD, FRCSEd(Tr&Orth); White, Timothy O. MD, FRCSEd (Tr&Orth), FFTEd; Amin, Anish K. PhD, FRCSEd(Tr&Orth)

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JBJS Reviews 11(4):e22.00239, April 2023. | DOI: 10.2106/JBJS.RVW.22.00239


  • » There is a spectrum of midtarsal injuries, ranging from mild midfoot sprains to complex Lisfranc fracture-dislocations.
  • » Use of appropriate imaging can reduce patient morbidity, by reducing the number of missed diagnoses and, conversely, avoiding overtreatment. Weight-bearing radiographs are of great value when investigating the so-called subtle Lisfranc injury.
  • » Regardless of the operative strategy, anatomical reduction and stable fixation is a prerequisite for a satisfactory outcome in the management of displaced injuries.
  • » Fixation device removal is less frequently reported after primary arthrodesis compared with open reduction and internal fixation based on 6 published meta-analyses. However, the indications for further surgery are often unclear, and the evidence of the included studies is of typically low quality. Further high-quality prospective randomized trials with robust cost-effectiveness analyses are required in this area.
  • » We have proposed an investigation and treatment algorithm based on the current literature and clinical experience of our trauma center.

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