Outcomes of Lisfranc Injuries Treated with Arthrex Internalbrace

Category: Midfoot/Forefoot Introduction/Purpose: Surgical treatment options for Lisfranc injuries include open reduction and internal fixation (ORIF) and primary arthrodesis. To date, various options of ORIF exist, including transarticular screws, dorsal plates, and more recently, flexible fixation methods such as suture button and InternalBrace (Arthrex Inc, Naples, FL).1-4 Flexible fixation techniques attempt to minimize post-surgical joint immobilization and prevent the articular cartilage damage seen with transarticular screws.4-6 Unlike other flexible fixation techniques, the InternalBrace avoids placement of a suture button on the medial cuneiform and prevents disruption of the tibialis anterior tendon.4,7 Patient outcomes have been reported for suture button and transarticular screw fixation; however, there is a lack of clinical data reported utilizing InternalBrace in Lisfranc injuries due to its recent FDA approval in 2019.1,2,4 Methods: A retrospective chart review was performed as part of a case study investigation of 9 patients who underwent ORIF with InternalBrace fixation by a single surgeon. Patients over 18 years of age were included. Results: The average follow-up time was 6.6 months (SD = 5.1 months). The average time to weight-bearing as tolerated was 6.8 weeks (n=9), while the average time to return to work/sport as tolerated was 14.3 weeks (n=7). The only complication noted at follow-up was hypersensitivity along the foot [1 (11%)] (Table 3). No hardware complications were noted at either 6-week and 12-week post-operative x-rays. Conclusion: In this retrospective chart review, the time to return to work/sport as tolerated was comparable to that of return to sport after ORIF with screws and combined bridge-plating (19.6 weeks) and suture button (19.4 weeks).8 Future research involving a larger cohort of patients is required and is currently being performed by our institution to further evaluate outcomes after use of the InternalBrace for Lisfranc injuries.