Abstract：
Lisfranc injuries have been rising in incidence and can cause significant and lasting morbidity. There is no consensus on the optimal surgical treatment for these injuries, be they primarily ligamentous or combined (bony and ligamentous). No study has ever followed Lisfranc injury patients postoperatively using advanced imaging. The purpose of this study was to compare the functional and radiographic outcomes of primarily ligamentous and combined osseous and ligamentous Lisfranc injuries treated operatively with reduction and fixation. We performed a retrospective review of all Lisfranc injuries treated operatively in a single institution over a 6-year period. Injuries were classified as primarily ligamentous or combined by independent evaluation of available computed tomography (CT) or magnetic resonance imaging. Outcomes were measured using the Short Musculoskeletal Function Assessment (SMFA). CT of 29 patients was performed at last follow-up to evaluate reduction and degenerative changes. Of the 56 patients identified, 38 were available for follow-up. The average follow-up was 3.8 years. There were 26 combined injuries and 12 primarily ligamentous injuries. Outcomes were excellent in all patients and there was no statistical difference in SMFA scores in any category between the groups. On follow-up CT, all injuries were anatomically reduced, and 26 of 29 patients had degenerative changes. Our results support that reduction and stable fixation of Lisfranc injuries may be suitable treatment regardless of classification as combined or primarily ligamentous. Future larger-scale prospective studies should be pursued to supplement existing data.
摘要：
Lisfranc伤害的发生率一直在上升，并可能导致严重而持久的发病率。对于这些损伤的最佳手术治疗尚无共识，它们主要是韧带或结合（骨和韧带）。没有研究随访Lisfranc损伤患者术后使用先进的成像。这项研究的目的是比较通过复位和固定手术治疗的主要韧带和骨性和韧带性Lisfranc损伤的功能和影像学结果。我们对6年内在单个机构中手术治疗的所有Lisfranc损伤进行了回顾性审查。通过对可用的计算机断层扫描（CT）或磁共振成像的独立评估，将损伤分类为主要韧带或合并。使用短肌肉骨骼功能评估（SMFA）测量结果。最后对29例患者进行了CT检查，以评估复位和退行性改变。在确定的56名患者中，38人可用于随访。平均随访3.8年。合并受伤26例，主要是韧带受伤12例。所有患者的预后均良好，两组之间的任何类别的SMFA评分均无统计学差异。在CT随访中,所有的损伤在解剖学上都减少了,29例患者中有26例出现退行性改变。我们的结果支持，无论分类为合并还是主要韧带，Lisfranc损伤的复位和稳定固定都可能是合适的治疗方法。未来应进行更大规模的前瞻性研究以补充现有数据。
