Outcome after nonoperative treatment of stable Lisfranc injuries. A prospective cohort study.

Abstract Background The aim of this study was to evaluate the outcome after nondisplaced and stable Lisfranc injuries. Methods 26 patients with injuries to the Lisfranc joint complex detected on CT scans, but without displacement were tested to be stable using a fluoroscopic stress test. The patients were immobilized in a non-weightbearing short leg cast for 6 weeks. The final follow-up was 55 (IQR 53 - 60) months after injury. Results All the Lisfranc injuries were confirmed to be stable on follow-up weightbearing radiographs at a minimum of 3 months after injury. Median American Foot and Ankle Society (AOFAS) midfoot score at 1-year follow-up was 89 (IQR 84 - 97) and at final follow-up 100 (IQR 90 - 100); The AOFAS score continued to improve after 1-year (P=.005). The median visual analog scale (VAS) for pain was 0 (IQR 0 - 0) at the final follow-up. One patient had radiological signs of osteoarthritis at 1-year follow-up. Conclusion Stable Lisfranc injuries treated nonoperatively had an excellent outcome in this study with a median follow-up of 55 months. The AOFAS score continued to improve after 1 year.