Arthrodesis Tarsometatarsal in Lisfranc Fracture: Comparison of Different Fixing Methods

Abstract

Category: Midfoot/Forefoot; Trauma Introduction/Purpose: Lisfranc fractures are rare, but with a high degree of morbidity. Post-traumatic degenerative changes that result in pain and deformity, are common; with arthrodesis being a treatment option. There are several implants for midfoot arthrodesis, but with little literature regarding the best method for achieve bone fusion. We analice the fusion rates, comparing different joint stabilization techniques. Methods: A retrospective descriptive study of 20 patients with post traumatic osteoarthritis of the midfoot was performed, who underwent midfoot arthrodesis, between January 2016 - January 2018. The comparison between arthrodesis techniques with compression plate (CP) vs plates and / or screws (PS) was made. Data analysis was performed with SPSS software. Results: The fusion times were compared between the 2 groups, CP 18.7 (+- 8.01) vs PT 16.86 (+- 11.5) weeks, without significant differences. There were also no significant differences when comparing the discharge times between the 2 groups, CP 8 (+- 1.84) vs PS 9 weeks (+- 2.36) (p = 0.312). However, when comparing the proportion of complications between both groups, the CP group has lesser than the PS group (42.8% vs 83.3%). This difference was not statistically significant (p = 0.95) although there is a tendency for CP to have fewer complications. In addition, the proportion of complications in primary vs. secondary arthrodesis, 25% vs. 75% respectively, was compared, finding statistically significant differences (p = 0.028) Conclusion: At the moment, there is a lack of evidence to recommend the exclusive use of implants. However, when comparing complications between both groups, there would be a tendency that the use of compression plates would have fewer complications. In addition, it could be inferred that in patients with lesions with greater joint destruction, primary arthrodesis is valid as an option.