The Use of Dorsal Bridge Plate Fixation in the Operative Management of Lisfranc Injuries – A Retrospective Cohort Study at Medium Term Follow-Up

• Published in: Foot (Edinburgh, Scotland) Scotland), 2024-03, Vol.58, p.102061-102061, Article 102061
• Main Authors: Davey, Martin S., O’Sullivan, David, McCabe, Fergus J., McQuail, Paula, Kearns, Stephen R.
• Format: Article
• Language: English
• Subjects: Dorsal Bridge Plate; Lisfranc; ORIF; Removal of Metal
• ISSN: 0958-2592; 1532-2963
• DOI: 10.1016/j.foot.2023.102061

Traditionally, early surgical management of Lisfranc injuries with transarticular screws (TAS) was deemed to be the optimal treatment. However, concerns of potential iatrogenic articular cartilage disruption has led to discrepancies in opinion amongst surgeons, with many surgeons now utilizing dorsal bridge plates (DBP) for ORIF of Lisfranc injuries. This study sought to investigate the clinical outcomes at medium-term follow-up of consecutive patients in our institution who underwent ORIF with DBP for Lisfranc injuries. All consecutive patients who underwent ORIF with DBPs for Lisfranc injuries were identified. Outcomes of interest included; visual analogue scale (VAS), functional foot index (FFI), American Orthopaedic Foot & Ankle Surgeons (AOFAS) hindfoot scores, and complications. Overall, 37 consecutive patients (24 males) with a mean age of 34.8 ± 13.0 years underwent ORIF with DBPs for lisfranc injuries. After a mean 48.3 ± 28.7 months, the mean reported AOFAS and FFI scores were 77.4 ± 23.8 and 31.9 ± 32.7 respectively, with satisfactory reported pain scores as measured by VAS post-operatively at rest and whilst walking (2.2 ± 2.5 and 3.1 ± 2.6 respectively). The reported satisfaction rate was 86.5% (32/37). Overall, 25 patients (67.6%) had subsequent removal of metal or were listed for same, 88% (22/25) of whom did so electively in the absence of broken screws or infection. This study found that the use of Dorsal Bridge Plates for Open Reduction and Internal Fixation of Lisfranc Injuries resulted in satisfactory functional outcomes, high rates of patient-reported satisfaction and a low complication rate at medium-term follow-up. Level IV; Retrospective Series of Consecutive Patients •This study examined the use of dorsal bridge plating for ORIF of Lisfranc Injuries resulted in satisfactory functional outcomes and high rates of patient-reported satisfaction in the medium-term.•The majority of patients opt for removal of their DBP predominantly in an elective setting, which was previously believed to encourage early range of motion for rehabilitation at the Lisfranc joint.•This study found no significant differences in reported pain and functional outcomes in the medium-term in patients who underwent DBP removal when compared to those who did not elect for removal of their DBP.