Abstract：
Midfoot fractures and dislocations are infrequent and functional outcomes following Lisfranc injuries have not been well described. The purpose of this project was to explore functional outcomes following operative treatment of high-energy Lisfranc injury.
A retrospective cohort of 46 adults with tarsometatarsal fractures and dislocations treated at a single Level 1 trauma center were reviewed. Demographic, medical, social, and injury features of these patients and their injuries were recorded. Foot Function Index (FFI) and Short Musculoskeletal Function Assessment (SMFA) surveys were collected after mean 8.7 years\' follow-up. Multiple linear regression was performed to identify independent predictors of outcome.
Forty-six patients with mean age 39.7 years completed functional outcome surveys. Mean SMFA scores were 29.3 (dysfunction) and 32.6 (bothersome). Mean FFI scores were 43.1 (pain), 43.0 (disability), and 21.7 (activity), with a mean total score of 35.9. FFI pain scores were worse than published values for fractures of the plafond (33, P = .04), distal tibia (33, P = .04), and talus (25.3, P = .001). Lisfranc injury patients reported worse disability (43.0 vs 29, P = .008) and total FFI scores (35.9 vs 26, P = .02) compared with distal tibia fractures. Tobacco smoking was an independent predictor of worse FFI (P < .05) and SMFA emotion and bothersome scores (P < .04). Chronic renal disease was a predictor of worse FFI disability (P = .04) and SMFA subcategory scores (P < .04). Male sex was associated with better scores in all SMFA categories (P < .04). Age, obesity, or open injury did not affect functional outcomes.
Patients reported worse pain by FFI after Lisfranc injury compared to other injuries about the foot and ankle. Tobacco smoking, female sex, and preexisting chronic renal disease are predictive of worse functional outcome scores, warranting further study in a larger sample, as well as counseling of long-term consequences of this injury.
Level IV, retrospective, prognostic.
A retrospective cohort of 46 adults with tarsometatarsal fractures and dislocations treated at a single Level 1 trauma center were reviewed. Demographic, medical, social, and injury features of these patients and their injuries were recorded. Foot Function Index (FFI) and Short Musculoskeletal Function Assessment (SMFA) surveys were collected after mean 8.7 years\' follow-up. Multiple linear regression was performed to identify independent predictors of outcome.
Forty-six patients with mean age 39.7 years completed functional outcome surveys. Mean SMFA scores were 29.3 (dysfunction) and 32.6 (bothersome). Mean FFI scores were 43.1 (pain), 43.0 (disability), and 21.7 (activity), with a mean total score of 35.9. FFI pain scores were worse than published values for fractures of the plafond (33, P = .04), distal tibia (33, P = .04), and talus (25.3, P = .001). Lisfranc injury patients reported worse disability (43.0 vs 29, P = .008) and total FFI scores (35.9 vs 26, P = .02) compared with distal tibia fractures. Tobacco smoking was an independent predictor of worse FFI (P < .05) and SMFA emotion and bothersome scores (P < .04). Chronic renal disease was a predictor of worse FFI disability (P = .04) and SMFA subcategory scores (P < .04). Male sex was associated with better scores in all SMFA categories (P < .04). Age, obesity, or open injury did not affect functional outcomes.
Patients reported worse pain by FFI after Lisfranc injury compared to other injuries about the foot and ankle. Tobacco smoking, female sex, and preexisting chronic renal disease are predictive of worse functional outcome scores, warranting further study in a larger sample, as well as counseling of long-term consequences of this injury.
Level IV, retrospective, prognostic.
摘要：
■中足骨折和脱位很少见，Lisfranc损伤后的功能结局尚未得到很好的描述。该项目的目的是探索高能Lisfranc损伤手术治疗后的功能结果。
■回顾性队列研究了在一个1级创伤中心治疗的46名成人的骨掌骨折和脱位。人口统计,medical,社会,并记录了这些患者的受伤特征及其受伤情况。平均随访8.7年后，收集了足功能指数（FFI）和短肌肉骨骼功能评估（SMFA）调查。进行多元线性回归以确定结果的独立预测因子。
■46名平均年龄39.7岁的患者完成了功能结局调查。平均SMFA评分分别为29.3（功能障碍）和32.6（麻烦）。平均FFI评分为43.1（疼痛），43.0（残疾），和21.7（活动），平均总分35.9分。FFI疼痛评分比发表的平台骨折的值更差（33，P=.04），胫骨远端（33，P=.04），和距骨（25.3，P=.001）。与胫骨远端骨折相比，Lisfranc损伤患者报告的残疾程度更差（43.0vs29，P=.008）和总FFI评分（35.9vs26，P=.02）。吸烟是FFI较差（P<.05）和SMFA情绪和烦恼评分（P<.04）的独立预测因子。慢性肾脏疾病是FFI残疾（P=.04）和SMFA亚类评分（P<.04）较差的预测因子。在所有SMFA类别中，男性与较好的得分相关(P<.04)。年龄,肥胖，或开放性损伤不影响功能结局.
■与脚和脚踝的其他损伤相比，Lisfranc损伤后FFI疼痛加重。吸烟,女性性别,先前存在的慢性肾脏疾病预示着较差的功能预后评分，保证在更大的样本中进行进一步的研究，以及这种伤害的长期后果的咨询。
■四级，回顾性,预后。
■回顾性队列研究了在一个1级创伤中心治疗的46名成人的骨掌骨折和脱位。人口统计,medical,社会,并记录了这些患者的受伤特征及其受伤情况。平均随访8.7年后，收集了足功能指数（FFI）和短肌肉骨骼功能评估（SMFA）调查。进行多元线性回归以确定结果的独立预测因子。
■46名平均年龄39.7岁的患者完成了功能结局调查。平均SMFA评分分别为29.3（功能障碍）和32.6（麻烦）。平均FFI评分为43.1（疼痛），43.0（残疾），和21.7（活动），平均总分35.9分。FFI疼痛评分比发表的平台骨折的值更差（33，P=.04），胫骨远端（33，P=.04），和距骨（25.3，P=.001）。与胫骨远端骨折相比，Lisfranc损伤患者报告的残疾程度更差（43.0vs29，P=.008）和总FFI评分（35.9vs26，P=.02）。吸烟是FFI较差（P<.05）和SMFA情绪和烦恼评分（P<.04）的独立预测因子。慢性肾脏疾病是FFI残疾（P=.04）和SMFA亚类评分（P<.04）较差的预测因子。在所有SMFA类别中，男性与较好的得分相关(P<.04)。年龄,肥胖，或开放性损伤不影响功能结局.
■与脚和脚踝的其他损伤相比，Lisfranc损伤后FFI疼痛加重。吸烟,女性性别,先前存在的慢性肾脏疾病预示着较差的功能预后评分，保证在更大的样本中进行进一步的研究，以及这种伤害的长期后果的咨询。
■四级，回顾性,预后。
