Return to Sport after Surgical Treatment of Lisfranc Injuries in Athletes: A Retrospective Case Series

Abstract

Introduction

A Lisfranc injury can be a devastating injury in athletes,
and if inadequately treated, may lead to chronic pain and loss
of function. The purpose of this study was to determine the rate and
time until return to sport after surgical fixation for a ligamentous Lisfranc
injury. We hypothesized that open reduction and screw fixation
of a ligamentous Lisfranc injury can be a successful treatment in the
athletic population and allow patients to return to sport at close to
their preinjury level of play.

Methods

All patients who were analyzed underwent repair of a
ligamentous Lisfranc injury with open reduction and screw fixation
by a single surgeon, were between 18 - 40 years old at time of their
final follow up, and were identified as being an athlete (either recreational
or competitive). Eligible patients were given a questionnaire
that included if they were able to return to sport, time until return to
sport, subjective percentage of pre-injury level of play, current pain
(0 - 10), and complications.

Results

Eleven patients were identified as athletes. Ten (91%) were
available for follow-up with a mean of 36.5 months (range, 14 - 60).
The average age was 25.4 years (range, 15 - 37) at time of surgery.
Eighty percent (8/10) were able to return to sport. The average time
until return to sport was 29.4 weeks (range, 22 - 52) with an average
subjective value of their pre-injury level of play of 87% (range, 70 -
100%). However, 67% (6/9) of the athletes had occasional pain with
sport with an average pain level of 2.1 (range, 0 - 5). Two patients
had complications, a superficial infection and a deep vein thrombosis.

Conclusion

Most athletes were able to return to sport after undergoing
open reduction and internal fixation of a ligamentous Lisfranc
injury by less than 30 weeks post-surgery with a subjective value of
87% of their previous function. However, the majority of the patients
also experienced some residual pain with their respective sport.
These findings suggested that athletes with a ligamentous Lisfranc
injury can have reliably good outcomes with operative repair.