Flexible Tightrope versus rigid Lisfranc screw fixation for ligamentous Myerson type B2 Lisfranc injury:a mid-term analysis
Objective:To compare the clinical efficacy of flexible Tightrope and rigid Lisfranc screw fixation for ligamentous Myserson type B2 Lisfranc injury.Methods:A retrospective analysis of clinical data from 28 patients with ligamentous Myserson type B2 Lisfranc injury admitted from February 2015 to June 2019 was performed.Patients were divided into two groups based on the different fixation methods:15 cases with traditional Lisfranc screw,and 13 cases with flexible Tightrope.Imaging examination was used to evaluate the maintenance of reduction and the presence of joint degeneration.The American Orthopedic Foot and Ankle Society(AOFAS)midfoot scale,foot function index(FFI),and visual analog scale(VAS)for pain were used to evaluate the clinical outcomes.Complications were recorded.Results:Twenty-eight patients were followed up for 36-75 months,with an average follow-up of(57.9±11.1)months.At 6 months postoperatively,the AOFAS midfoot score,FFI,and VAS scores in patients with Tightrope fixation were significantly better than those with screw fixation(all P＜0.05).However,there were no statistically significant differences between the two groups at 1 year postoperatively or the final follow-up(both P＞0.05).In the screw fixation group,12 cases(80.0％)underwent secondary surgery for screw removal between 7 and 12 months postoperatively,with an average removal time of(9.8±1.3)months postoperatively.In the flexible fixation group,one case underwent a secondary surgery for removal due to soft tissue irritation caused by the locking plate at 12 months postoperatively.None of the patients in either group developed traumatic arthritis.Conclusions:For ligamentous Myserson type B2 Lisfranc injury,flexible Tightrope fixation can achieve clinical outcomes comparable to those with Lisfranc screw fixation,with the advantages of faster early postoperative recovery and reduced possibility of secondary surgery for internal fixation removal.
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