Tarsometatarsal (Lisfranc) luxation fractures

There is stil controversy concerning the best management approach for Lisfranc
luxation fractures. The choice is between conservatieve treatment using Plaster
of Paris, or operative treatment (open surgery, percutaneous approach, primary
arthrodesis). Likewise, the type of osteosynthesis material to be used
(Kirschner wires versus screws) is still undecided. Lisfranc luxation fractures
are considered as unstable fractures. Patients sometimes experience complaints
for a prolonged period of time, and a delayed or inadequate could have
detrimental consequences. Therefore, additional research is needed in order to
identify the best treatment strategy.

Primairy aim:
To determine the AOFAS Midfoot functional outcome score after operative or
non-operative treatment of patients whou sustained a Lisfranc luxation
fracture, with a minimum follow-up of 2 years.

Secundairy aims:
1. To determine the effect of operative or non-operative treatment on the
health-related quality of live (SF-36) and overall satisfaction with the
treatment outcome (VAS) of patients who sustained a Lisfranc luxation fracture .
2. To determine the prognostic value oof the degree of fracture reduction
(anatomic reduction or > 2 mm dislocation) and the type of osteosynthesis
material (Kirschner wires or screws) on the functional outcome score.
3. To determine the pressure characteristics of the affected foot versus the
contralateral side in patients treated operatively or non-operatively.

It is expected that patients with surgically managed fractures will a report
higher outcome score and less deviations in pressure characteristics than
patients with conservatively managed fractures.

Retrospective cohort study

Patients will be asked to come to the outpatient department once. During that
visit, three X-rays will be taken both feet (AP, 3/4 and lateral image).
Patients will be asked to complete three questionnaires (AOFAS midfoot, SF-36,
and VAS) and to walk on a pressure mat (2 meter) five times. Due to the
radiation exposure of the X-rays, pregnant women are excluded from
participation.