Assessment of sensorimotor and functional differences between patients with surgically treated partially incongruent Lisfranc injuries and healthy controls: a cross-sectional study.

INTRODUCTION

Lisfranc injuries are relatively rare but associated with a notoriously poor prognosis despite significant advances in their surgical treatment. This study aimed to investigate changes in plantar sensation, ankle proprioception, mobility, balance, and isokinetic strength in patients treated by open reduction and internal fixation (ORIF) for partially incongruent Lisfranc injuries.

MATERIALS AND METHODS

This retrospective cross-sectional study was conducted at a tertiary care hospital. The patient group consisted of 12 patients (9 males, mean age = 39.16 ± 13.57 years) who were treated with ORIF for a Myerson type B partially incongruent Lisfranc injury between 2020 and 2023. Measurements were conducted at an average of 20 (20–42) months post-surgery. The control group included 11 healthy participants (8 males, mean age: 37 ± 8.69 years) with no known orthopedic conditions. Sole sensation, ankle proprioception, ankle dorsiflexion (DF) and plantarflexion (PF) muscle strength and endurance were measured with CYBEX 350 isokinetic dynamometer, along with dynamic balance, ankle mobility, and PF endurance.

RESULTS

The patient group exhibited significant reductions in mid-foot plantar sensation ( = 0.019), as well as impairments in active angle replication at 7° DF, 7° PF, and 14° PF ( = 0.049,  < 0.001,  < 0.001, respectively). Additionally, marked declines were observed in both dorsiflexion strength and endurance ( < 0.001) and plantarflexion endurance ( = 0.007). Furthermore, this group demonstrated decreased dynamic balance ( = 0.021), particularly in the anterior direction ( = 0.001), alongside diminished ankle mobility ( = 0.001) and isotonic endurance of the ankle plantar flexor muscles ( = 0.001).

CONCLUSIONS

Ankle mobility, balance, and muscle endurance can be limited as a result of substantial proprioceptive losses, decreased midfoot plantar sensation, and poor active angle replication following surgery for Lisfranc injury, according to this study. Emphasizing focused proprioception and balance training in post-operative rehabilitation is crucial to enhance recovery and prevent long-term complications.