Cost comparison and complication rate of Lisfranc injuries treated with open reduction internal fixation versus primary arthrodesis

Barnds, Brandon; Tucker, William; Morris, Brandon; Tarakemeh, Armin; Schroeppel, John Paul; Mullen, Scott; Vopat, Bryan G.

doi:10.1016/j.injury.2018.10.002

Cited by 20 publications

(8 citation statements)

References 17 publications

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“…Barnds et al conducted a retrospective study comparing costs between the 2 treatment methods, and they found that PA is significantly more expensive, with the average cost of care associated with PA and ORIF being $5005.82 and $3961.97, respectively ( P = 0.045). 16 Alternatively, Albright et al conducted a formal cost-effectiveness analysis using a Markov model while also incorporating long-term costs, quality-adjusted life years, and incremental cost per quality-adjusted life year gained; with these additional variables, they found that ORIF actually costs more overall. 17 To further elucidate this area of concern, van den Boom et al is currently leading an ongoing multicenter randomized controlled trial (RCT) evaluating cost-effectiveness of PA versus ORIF for Lisfranc injuries.…”

Section: Discussionmentioning

confidence: 99%

Functional Outcomes of Primary Arthrodesis (PA) Versus Open Reduction and Internal Fixation (ORIF) in the Treatment of Lisfranc Injuries

Aneja

Gal

Dawson

et al. 2023

Journal of Orthopaedic Trauma

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Objectives: To determine whether primary arthrodesis (PA) or open reduction and internal fixation (ORIF) results in better functional outcomes through patient-reported outcome measures (PROMs). Reoperation rates and surgical characteristics among the 2 groups are evaluated as well. Design: A retrospective cohort study. Setting: Level 1 trauma center. Patients: Eighty-one patients treated using PA or ORIF for Lisfranc injuries between January 2010 and January 2019. Main Outcome Measurements: PROMs were collected using the validated Foot and Ankle Ability Measure questionnaire. Follow-up ranged from 1 to 10 years posttreatment. Results: Two hundred patients underwent ORIF, and 72 patients underwent PA. Eighty-one of 272 patients responded to the questionnaire. The Foot and Ankle Ability Measure revealed activities of daily living subscores for PA and ORIF of 69.78 ± 18.61 and 73.53 ± 25.60, respectively (P = 0.48). The Sports subscores for PA (45.81 ± 24.65) and ORIF (56.54 ± 31.13) were not significantly different (P = 0.11). Perceived levels of activities of daily living (P = 0.32) and Sports (P = 0.81) function, compared with preinjury levels, were also not significantly different between the 2 groups. Rates of reoperation were nearly identical for PA (28.1%) and ORIF (30.6%) (P = 1.00). Conclusion: Our results suggest that neither PA nor ORIF is superior regarding functional outcomes or rates of reoperation in the surgical treatment of Lisfranc injuries when appropriately triaged by the treating surgeon. Level of Evidence: Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.

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Section: Discussionmentioning

confidence: 99%

Functional Outcomes of Primary Arthrodesis (PA) Versus Open Reduction and Internal Fixation (ORIF) in the Treatment of Lisfranc Injuries

Aneja

Gal

Dawson

et al. 2023

Journal of Orthopaedic Trauma

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“…The choice between ORIF and primary arthrodesis is controversial regarding traumatic injuries of the midfoot [17] . Limited data is available in the literature concerning outcomes after acute arthrodesis for Chopart injuries.…”

Section: Discussionmentioning

confidence: 99%

An unusual midfoot injury pattern: Navicular-cuneiform and calcaneal-cuboid fracture-dislocation

Fares

Orfeuvre

Ezz

et al. 2022

Trauma Case Reports

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“… 42 Two studies have reviewed the costs of ORIF and PA: one found that PA was significantly more expensive and, in contrast, one found PA to be more cost-effective. 43 , 44 All of the reported studies measuring the cost-effectiveness only measured the medical costs, such as professional care and diagnostic tests. We suggest also measuring the patient and family costs caused by reduced productivity and hospital visits, since Lisfranc injuries may often cause long-term complaints.…”

Section: Discussionmentioning

confidence: 99%

Lisfranc injuries: fix or fuse?

et al. 2021

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Aims This systematic review and meta-analysis was conducted to compare open reduction and internal fixation (ORIF) with primary arthrodesis (PA) in the treatment of Lisfranc injuries, regarding patient-reported outcome measures (PROMs), and risk of secondary surgery. The aim was to conclusively determine the best available treatment based on the most complete and recent evidence available. Methods A systematic search was conducted in PubMed, Cochrane Controlled Register of Trials (CENTRAL), EMBASE, CINAHL, PEDro, and SPORTDiscus. Additionally, ongoing trial registers and reference lists of included articles were screened. Risk of bias (RoB) and level of evidence were assessed using the Cochrane risk of bias tools and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) tool. The random and fixed-effect models were used for the statistical analysis. Results A total of 20 studies were selected for this review, of which 12 were comparative studies fit for meta-analysis, including three randomized controlled trials (RCTs). This resulted in a total analyzed population of 392 patients treated with ORIF and 249 patients treated with PA. The mean differences between the two groups in American Orthopedic Foot and Ankle Society (AOFAS), VAS, and SF-36 scores were -7.41 (95% confidence interval (CI) -13.31 to -1.51), 0.77 (95% CI -0.85 to 2.39), and -1.20 (95% CI -3.86 to 1.46), respectively. Conclusion This is the first study to find a statistically significant difference in PROMs, as measured by the AOFAS score, in favour of PA for the treatment of Lisfranc injuries. However, this difference may not be clinically relevant, and therefore drawing a definitive conclusion requires confirmation by a large prospective high-quality RCT. Such a study should also assess cost-effectiveness, as cost considerations might be decisive in decision-making. Level of Evidence: I Cite this article: Bone Jt Open 2021;2(10):842–849.

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Cost comparison and complication rate of Lisfranc injuries treated with open reduction internal fixation versus primary arthrodesis

Cited by 20 publications

References 17 publications

Functional Outcomes of Primary Arthrodesis (PA) Versus Open Reduction and Internal Fixation (ORIF) in the Treatment of Lisfranc Injuries

Functional Outcomes of Primary Arthrodesis (PA) Versus Open Reduction and Internal Fixation (ORIF) in the Treatment of Lisfranc Injuries

An unusual midfoot injury pattern: Navicular-cuneiform and calcaneal-cuboid fracture-dislocation

Lisfranc injuries: fix or fuse?

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