What is the prognosis of Lisfranc fracture dislocation?

Updated: Apr 20, 2020
  • Author: Nirmal Tejwani, MD, MPA; Chief Editor: Thomas M DeBerardino, MD  more...
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Stable anatomic alignment is the best predictor of outcome. [9, 10, 11] The presence of fractures and/or articular destruction leads to poorer results, regardless of alignment. The incidence of posttraumatic arthritis reportedly ranges from 0% to 58%. [12] One study reported that as many as 25% of patients develop posttraumatic arthritis even after fixation. This same study showed that there was no difference between acute and delayed (>6 weeks) surgical fixation. Purely ligamentous injuries seemed to have poorer outcomes. [5]

Good results are achieved from open reduction with internal fixation (ORIF) at up to 6 weeks, but poor outcomes are seen after this time, arising from articular destruction, malalignment, and poor soft-tissue envelope.

Schepers et al performed a pedobarographic study that showed reduced contact time and reduced contact area of the forefoot in 26 patients relative to the uninvolved side. [13] Whereas these patients expressed good satisfaction with the procedure (primary ORIF [PORIF]), with Short Form (SF)-36 scores averaging 101, their functional scores were only fair, with a median American Orthopaedic Foot and Ankle Score (AOFAS) of 72 and a Visual Analogue Scale (VAS) score of 7.

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