[Osteoarthritis after open reducation and internal fixation of lisfranc fracture]

ABSTRACT

Open reduction and internal fixation is the standard surgical approach for lisfranc fracture, however, osteoarthritis is a long term complication. We surveyed the frequency of osteoarthritis after open reduction and internal fixation of lisfranc fracture and its associated factors including accompanied fracture, delayed diagnosis and open or closed fracture. Patients who suffered from lisfranc fracture between 1997 and 2005 and underwent open reduction and internal fixation at least 2 years ago were included. Tarsometatarsal osteoarthritis was investigated among these patients. Of 94 patients, 44 were included with a mean follow up duration of 36 months, among whom, 34 had anatomic reduction while 12 [35.3%] developed osteoarthritis. Meanwhile, of 10 patients with non-anatomic reduction, 8 [80%] developed osteoarthritis. The difference is statistically significant [p=0.004]. Unfortunately, 4 patients [9.1%] were misdiagnosed during the first visit, while 10 [22.7%] patients referred late. Accompanied fractures were reported in 34 [77%] patients. Higher prevalence of osteoarthritis among patients with non-anatomic reduction support the prior theory that open reduction and internal fixation could prevent further degenerative changes in lisfranc joint