purpose. To assess mid-term outcome of screw and wire fixation for Lisfranc fracture dislocations to determine the risk factors of post-traumatic arthritis. Methods. 15 men and 4 women aged 21 to 58 (mean, 41) years with Lisfranc fractures underwent open/ closed reduction and internal fixation (using screw and wire). Fractures were classified as homolateral (n=7), isolated (n=7), and divergent (n=5). Six patients had open fractures; 8 patients injured 5 tarsometatarsal joints; and 6 patients had pure ligamentous injury. Outcome (pain, function, and cosmesis) was assessed using the Maryland foot score and the American Orthopedic Foot and Ankle Society (AOFAS) score. Weight-bearing radiographs were evaluated for non-union, subluxation, malalignment, and post-traumatic arthritis. results. Patients were followed up for 24 to 40 (mean, 30) months. Patients with anatomic reduction (n=14) achieved higher mean AOFAS foot score (79.3 vs. 67.5, p=0.0007) and Maryland foot score (80.4 vs.