Comparação dos resultados do tratamento de lesões agudas e tardias da articulação de Lisfranc

Abstract

Objective A retrospective comparison of treatment difficulties and treatment outcomes in Lisfranc joint injuries with late and early diagnosis. Methods The study group consisted of 10 patients diagnosed and treated properly within six months to 20 years of the accident causing the injury (mean six years). The control group consisted of the same number of randomly selected patients with a similar type of injury treated immediately after the accident. Mean follow-up was 13 years in the study group and eight years in the control group. The analysis evaluated the causes of the delay and the foot function at the time of follow up, measured using the AOFAS Midfoot Scale and the Lublin Foot Functional Score. The scores of the patients were analyzed using the non-parametric Mann-Whitney U test and the non-parametric Wilcoxon test. Results The control group had statistically significantly better scores on both scales. Conclusion The main cause of treatment delay was misdiagnosis by the primary care physician. Level of Evidence III, Retrospective Comparative Study.

Long-term Follow-up of Lisfranc Injuries Treated With Open Reduction Internal Fixation Patient-Reported Outcomes

“…23 Furthermore, early treatment has been shown to provide better outcomes than delayed treatment. 22 Complications post injury include midfoot arthritis, chronic pain, and pes planus, of which arthritis is the most common. 2 The development of osteoarthritis does not always require treatment, even when symptomatic; one study found that of 33 patients with symptomatic arthritis, only 4 patients had a secondary procedure.…”

“…23 Furthermore, early treatment has been shown to provide better outcomes than delayed treatment. 22…”

“…Pertaining to the foot, these outcome scores include but are not limited to the American Orthopaedic Foot & Ankle Society (AOFAS), Foot Function Index, Foot and Ankle Outcome Score, Foot and Ankle Ability Measure, visual analog scale–foot and ankle (VAS-FA), and Lublin Foot Functional Score. 12,16,18,22,24 Owing to the relative rarity of Lisfranc injuries in addition to challenges faced in data collection for traumatic orthopedic injuries, there is a paucity of outcomes literature on Lisfranc injuries.…”

Missed Lisfranc injuries—surgical vs conservative treatment

“…The radiograph of a foot could be challenging, and the images may require review by a specialist radiologist or an orthopaedic surgeon to avoid missing subtle injuries [ 7 ]. In one study, the majority of the patients were missed by primary physicians who may lack the experience to recognise subtle Lisfranc injuries on plain radiographs [ 8 ]. We noticed similar findings in our study as all the patients missed in our study were first seen in accident and emergency.…”