Mid-term biomechanical gait analysis of osteosynthesis in bony Lisfranc injuries

BACKGROUND: Injuries to the tarsometatarsal joint (Lisfranc injuries) significantly affect foot biomechanics and gait. Surgical treatment is often necessary for fractures or unstable ligamentous Lisfranc injuries. However, data on midterm outcomes regarding gait and function remain limited. We hypothesized that operative treatment restores biomechanical function and gait. METHODS: We retrospectively analyzed patients treated with osteosynthesis for Lisfranc injuries at our institution. Outcomes were assessed using subjective and objective measures (AOFAS, FAAM-G). Gait analysis included joint angle measurements, EMG, and pedobarography, comparing affected feet to the unaffected side and a matched group of healthy controls. RESULTS: Twelve patients (4 female, 8 male; mean age 44.3 years, range 25-64) were included. Gait analysis after osteosynthesis of Lisfranc injuries showed promising outcomes, with no significant differences in key pedobarometry parameters compared to the unaffected side and healthy individuals. CONCLUSIONS: Osteosynthesis for Lisfranc injuries enables restoration of normal gait patterns and good midterm clinical outcomes. LEVEL OF EVIDENCE: Level III - Retrospective Comparative Study.