• Kaissar Yammine, Karl Boulos, and Chahine Assi.
• Department of Orthopedic Surgery, Lebanese American University Medical Center-Rizk Hospital, Lebanese American University School of Medicine, Lebanese American University, Beirut, Lebanon. cesaryam@gmail.com.
• Eur J Trauma Emerg Surg. 2021 Aug 1; 47 (4): 1221-1230.

PurposeThough uncommon, Lisfranc complex joint injuries constitute a therapeutic challenge. Two surgical methods are commonly used to treat such injuries: open reduction and internal fixation (ORIF) and primary arthrodesis (PA). The aim of this meta-analysis is to look for significant differences in the outcomes between these two techniques.MethodsA comprehensive search of databases including PubMed, Embase, Cochrane Library and Google Scholar was planned. Only studies with comparative design using ORIF/PA techniques were included. One randomized trial, one quasi-randomized trial and four of retrospective comparative studies met the inclusion criteria. Proportion meta-analysis was used to look for weighted frequencies of outcomes. Risk difference rate meta-analysis was conducted to look for significant differences between proportion rates.ResultsThe pooled sample included 269 patients [269 surgical procedures: 176 (65.4%) ORIF vs. 93 (34.6%) PA] with a mean follow-up period of 31.85 ± 16.14 months. Besides a similar radiological healing failure rate, meta-analytical results yielded better outcomes in favour of PA: lesser implant removal rate (P < 0.0001), better rate of return to full activities (P = 0.01) and satisfaction rate (P = 0.052). A double rate of revision for non-healing following ORIF was found but did not reach significance (P = 0.1).ConclusionsThis meta-analysis demonstrated that even with a similar union rate, PA could be a better option in treating Lisfranc complex joint injuries when compared to ORIF. There is a need for larger controlled sampled studies to research on this type of injuries.© 2019. Springer-Verlag GmbH Germany, part of Springer Nature.

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