Lisfranc Injuries of the Foot, Outcomes of Surgical Treatment in Sudanese Patients, 2017

Abstract

Background: Fracture dislocations involving the Lisfranc joint are rare; they represent only 0.2% of all the fractures. Open reduction and internal fixation of displaced or unstable Lisfranc injuries represents the gold standard for the treatment of this complex injuries. The recent establishment of specialized foot and ankle units in Sudan provided the chances to assess the outcome of surgical intervention for the Sudanese patients suffering these injuries as there are no previous work on this important condition. Objective: To evaluate the clinical and functional outcomes of open reduction and internal fixation of Lisfranc injuries of the foot. Material and Methods: In an, observational hospital-based case series study; a total of twenty-seven consecutive adults ± 40-years-old; with displaced ligamentous or osseous Lisfranc injuries, due to high and low energy foot trauma; January 2015 to January 2017 were recruited from the Foot and ankle clinics at Sharg-Elneel and Ibrahim Malik specialized hospitals in Khartoum, Sudan. Open reduction and internal fixation by screws ± Kirschner wire (K-wires) has been done to all patients after careful pre-operative assessment. At 6 months following surgery, patients were examined clinically and assessed using the American Orthopaedic Foot and Ankle Society (AOFAS) and foot function index. Results: The AOFAS rating scale of the 27 patients ranges between 73 and 97 with a mean of 85. Which indicates very good outcome, However, the foot function index (FFI) score ranges from 11 to 41 with a mean FFI of 18.85, which was consistent with the Good AOFAS Foot Functional Outcome score, reflecting ‘Good Foot Functional Outcome’. The timing of surgery was variable, from 1-3 weeks due post-trauma edema and swelling of the soft tissue. Conclusion: Surgical correction of Lisfranc injuries by open reduction and internal fixation is found to be a valid treatment, which is directly linked to a good clinical and functional outcome. Particularly in reducing post-operative pain.