Defining Operative Indications in Lisfranc Injuries: A Systematic Review
Issued Date
2023-01-01
Resource Type
ISSN
19386400
eISSN
19387636
Scopus ID
2-s2.0-85162938395
Journal Title
Foot and Ankle Specialist
Rights Holder(s)
SCOPUS
Bibliographic Citation
Foot and Ankle Specialist (2023)
Suggested Citation
Pearsall C., Arciero E., Gupta P., Bäcker H., Tantigate D., Trofa D.P., Vosseller J.T. Defining Operative Indications in Lisfranc Injuries: A Systematic Review. Foot and Ankle Specialist (2023). doi:10.1177/19386400231175376 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/87783
Title
Defining Operative Indications in Lisfranc Injuries: A Systematic Review
Other Contributor(s)
Abstract
Objective: The aim of this review was to determine operative indications for Lisfranc injuries. Methods: A systematic review using a MEDLINE literature search was performed using the index “Lisfranc Injury” from 1980 onward using PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines where applicable. Inclusion criteria were all clinical studies reporting on the management of Lisfranc injuries obtained via the search index, including case reports, review articles, cohort studies, and randomized trials. Non-English-language articles, inaccessible articles, those not relevant to the management of Lisfranc injuries (biomechanical, cadaveric, and technique articles), and those that did not explicitly state operative indications (vague or absent indications) were excluded. Results: After identifying 737 studies, the full text of 391 studies was reviewed, and 58 reports providing explicit operative indications were included in the final analysis. Fifty-one (81.1%) studies provided diastasis cutoffs varying ≥2 mm (35/58; 60.4%), ≥1 mm (13; 22.4%), and ≥3 mm (3; 5.2%); the diastasis location was most commonly unspecified (31/58; 53.5%) or varied between combinations of metatarsal, tarsal, cuboid, and cuneiform bones (20/58; 27.6%). Specific imaging criteria for surgery included an avulsion fracture or fleck sign (3/58; 5.2%), arch height loss (3/58; 5.2%), and a tear on magnetic resonance imaging (5; 8.6%). The 11 (19%) studies defining operative indications in terms of classification schemes used the Nunley and Vertullo (8/58; 13.8%), Myerson (2; 3.5%), and Buehren (1; 1.7%) systems. Twenty-one (36.2%) studies provided multiple operative indications. Conclusion: The most common Lisfranc operative indications among the limited reporting studies varied from a 1- to 3-mm diastasis across several locations. It is imperative for operative indications to be reported with an increased frequency and in a homogenous fashion to guide the clinical management of these subtle injuries. Levels of Evidence: Level IV; systematic Review.