Suture tape and headless compression screws in treatment of Lisfranc injury with comminuted fractures of the first and second proximal metatarsal bones

doi:10.12307/2025.145

Abstract

Abstract: BACKGROUND: Lisfranc ligament is an important structure to maintain the transverse and longitudinal arch of the foot. This injury is a serious middle-foot injury. Lisfranc ligamentous injuries are complex, and their treatment, along with the preferred method of fixation, is controversial.
OBJECTIVE: To compare the short-term efficacy of plate combined with Suture tape versus plate combined with headless compression screw in the treatment of Lisfranc injury with comminuted fractures of the 1st and 2nd proximal metatarsal bones.
METHODS: A retrospective analysis was performed on 48 patients with Lisfranc injury due to comminuted fractures of the 1st and 2nd proximal metatarsal bones in Seventh Department of Orthopedics, Dongguan Hospital of Traditional Chinese Medicine from January 2019 to June 2022. Among them, 25 were fixed with plate combined with Suture tape (observation group) and 23 were fixed with plate combined with headless compression screw (control group). Preoperative classification was performed according to Myerson classification system based on preoperative imaging data. Postoperative follow-up was performed according to fracture healing time, visual analog scale, and American Orthopaedic Foot and Ankle Society (AOFAS) criteria to assess the recovery of foot functions. Postoperative complications were compared and analyzed between the two groups.

RESULTS AND CONCLUSION: (1) All cases completed the operation successfully and obtained follow-up in the two groups. The postoperative follow-up time of the two groups was 12-36 months, with a mean of (18.0±5.42) months. (2) There were no significant differences in operation time and intraoperative blood loss between the two groups (P > 0.05). (3) The fracture healing time of observation group was slightly longer than that of control group (P < 0.05). (4) After 3, 6, and 12 months of follow-up, the visual analog scale score of the observation group was significantly lower than that of the control group (P < 0.05). (5) At 6 and 12 months after operation, AOFAS score of foot function in the observation group was significantly improved compared with the screw group at various time points after operation (P < 0.05), and was significantly higher than that before operation (P < 0.05). (6) The postoperative complications were 1 case of traumatic arthritis in the observation group and 1 case of incision infection, 1 case of screw fracture, and 2 cases of traumatic arthritis in the control group. There was no significant difference between the two groups (P > 0.05), considering the correlation with a small sample size. (7) It is indicated that as for the surgical method of Lisfranc injury with comminuted fractures of the 1st and 2nd proximal metatarsal bones, the application of plate combined with Suture tape internal fixation has a reliable effect in the treatment of Lisfranc joint injury, which can improve the function of the foot joint of patients, and has the advantages of less surgical trauma, fewer postoperative complications, and lower risk of long-term iatrogenic traumatic arthritis. Compared with headless compression screw, it is more beneficial to the recovery of foot function.

中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程

Key words: comminuted fractures of the 1st and 2nd proximal metatarsal bones, Lisfranc injury, plate, headless compression screw, Suture tape, internal fixation

CLC Number:

R459.9|R318|R687

Huang Haobo, Liang Xinyuan, Ye Guozhong, Xie Qingxiang, Su Boyuan. Suture tape and headless compression screws in treatment of Lisfranc injury with comminuted fractures of the first and second proximal metatarsal bones[J]. Chinese Journal of Tissue Engineering Research, 2025, 29(9): 1803-1809.

Figures/Tables 6

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