Vopat Bryan G, Vopat Matthew L, van Dijk Pim A D, Hazzard Sean, McKinnon Kayla, Asnis Peter D, Theodore George H
University of Kansas Medical Center, Kansas City, KS.
University of Kansas School of Medicine-Wichita, Wichita, KS.
Kans J Med. 2019 Nov 25;12(4):141-145. eCollection 2019 Nov.
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.
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.
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.
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.
跖跗关节损伤对运动员来说可能是一种极具破坏性的损伤,如果治疗不当,可能会导致慢性疼痛和功能丧失。本研究的目的是确定韧带性跖跗关节损伤手术固定后恢复运动的比率和时间。我们假设韧带性跖跗关节损伤的切开复位螺钉固定术在运动员群体中是一种成功的治疗方法,能让患者恢复到接近受伤前的运动水平。
所有接受分析的患者均由同一位外科医生进行韧带性跖跗关节损伤的切开复位螺钉固定修复术,最后一次随访时年龄在18至40岁之间,且被认定为运动员(业余或职业)。符合条件的患者会收到一份问卷,内容包括他们是否能够恢复运动、恢复运动的时间、受伤前运动水平的主观百分比、当前疼痛程度(0至10分)以及并发症情况。
确定有11名患者为运动员。其中10名(91%)可供随访,平均随访时间为36.5个月(范围14至60个月)。手术时的平均年龄为25.4岁(范围15至37岁)。80%(8/10)的患者能够恢复运动。恢复运动的平均时间为29.4周(范围22至52周),受伤前运动水平的主观平均百分比为87%(范围70至100%)。然而,67%(6/9)的运动员在运动时偶尔会疼痛,平均疼痛程度为2.1(范围0至5)。两名患者出现并发症,分别为浅表感染和深静脉血栓形成。
大多数运动员在韧带性跖跗关节损伤切开复位内固定术后不到30周就能恢复运动,主观功能恢复到之前的87%。然而,大多数患者在各自的运动中也会经历一些残留疼痛。这些发现表明,韧带性跖跗关节损伤的运动员通过手术修复可获得可靠的良好效果。