Comparison of Fixation Stability of the Novel Lisfranc Plate to Transarticular Screws

Abstract

Category: Midfoot/Forefoot, Trauma Introduction/Purpose: The objective of this study was to compare the stability of fixation of ligamentous Lisfranc injuries stabilized using two devices: a novel Lisfranc plate and conventional transarticular screws. Methods: A biomechanical cadaver model was developed to compare the fixation stability of a novel Lisfranc plate to that of traditional fixation, using transarticular screws. Thirteen pairs of cadaveric specimens were tested intact, after a simulated injury, and after implant fixation. Optical motion tracking was used to measure the three dimensional (3D) motion between each of the following four bones: first metatarsal, second metatarsal, first cuneiform, and second cuneiform. Testing included both cyclic abduction loading and cyclic axial loading. Results: Both the Lisfranc plate and screw fixation method provided stability such that the average 3D motions across the Lisfranc joint (between the second metatarsal and the first cuneiform), were between 0.2 and 0.4 mm under cyclic abduction loading and between 0.4 and 0.5 mm under cyclic axial loading. Comparing the stability of fixation between the Lisfranc plate and the screws, the differences in motion were all 0.3 mm or lower, with no significant differences (p > 0.16). Conclusion: Average 3D motions of the Lisfranc joint were 0.5 mm or below, whether fixed with the Lisfranc plate or the screws. Therefore, the Lisfranc plate provided comparable stability to the transarticular screws, which have been established as the gold standard for arthrodesis in Lisfranc injuries. Due to its anatomical placement, the Lisfranc plate may provide adequate support without risk of iatrogenic injury to the articular cartilage.