Functional outcomes of traumatic midfoot injuries |
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| Affiliation: | 1. University Medical Center Utrecht, Department of Surgery Utrecht, the Netherlands;2. Harvard Medical School Orthopedic Trauma Initiative, Massachusetts General Hospital, Department of Orthopaedic Surgery, Boston, MA, United States;1. Clinical Orthopaedics, Trauma Surgery and Rheumatology Management Unit, Hospital Universitario Virgen del Rocío, Seville, Spain;2. Department of Mechanical Engineering, University of Seville, Escuela Técnica Superior de Ingeniería, Seville, Spain;3. Department of Mining, Mechanical, Energy and Construction Engineering, University of Huelva, Campus Universitario La Rábida, Escuela Técnica Superior de Ingeniería, Palos de la Frontera (Huelva), Spain;1. Orthopaedic Surgery, Wright State University Department of Orthopaedic and Plastic Surgery, Dayton, OH, United States;2. Andrews Institute, Orthopaedics and Sports Medicine, Gulf Breeze, FL, United States;3. Premier Health Partners, Miami Valley Hospital Biosciences Center, Dayton, OH, United States;4. University of Massachusetts Department of Orthopedics and Physical Rehabilitation, North Worcester, MA, United States;1. Department of Trauma, University Hospital of Zurich, Raemistrasse 100, 8091 Zurich, Switzerland;2. Department of Orthopaedics and Traumatology, Clinic for Surgery, Waid City Hospital, Zurich, Switzerland;1. Department of Biomedical Engineering, University of Melbourne, Parkville, Victoria, 3010, Australia;2. Department of Surgery, Austin Health, Melbourne Medical School, The University of Melbourne, Parkville, Victoria, 3010, Australia;3. Department of Orthopaedic Surgery, Epworth Healthcare, Richmond, Victoria, 3121, Australia;1. Department of Trauma and Orthopaedics, Morriston Hospital, Abertawe BroMorgannwg University Health Board, Heol Maes Eglwys, Swansea SA6 6NL, United Kingdom;2. College of Medicine, Grove Building, Swansea University, Singleton Park, Swansea, SA2 8PP, United Kingdom |
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| Abstract: | IntroductionMidfoot injuries are rare injuries, often the result of high-energy trauma and occurring in the context of multiple trauma. This study aimed to evaluate functional outcomes and health-related quality of life after open reduction and internal fixation for midfoot injuries at a level 1 trauma center treating complex foot injuries.MethodsRetrospective single level 1 center study with follow-up by questionnaire. All adult patients who underwent open reduction and internal fixation (ORIF) for Lisfranc and/or Chopart injuries between 2000 and 2016 were included and invited to complete the American Orthopaedic Foot and Ankle Society (AOFAS) Midfoot Score, the EuroQOL Visual Analog Scale (EQ-VAS), and the EuroQOL five-dimensional questionnaire (EQ-5D-5L). Chart reviews were performed to collect demographic, injury, and treatment characteristics.ResultsForty patients with 45 midfoot injuries were included. Follow-up was available for 29 patients (31 feet), leading to a response rate of 83%. The majority of patients suffered high-energy trauma and nearly all patients had a concomitant injury. Secondary arthrodesis was performed in 7/45 injuries. Median AOFAS score was 64 (IQR 47–78). Higher injury severity score (ISS) was associated with poorer functionality as measured with the AOFAS Midfoot Score (p = 0.046), concomitant injuries were associated with lower quality of life (p = 0.01). EQ-5D scores were significantly lower when compared to the Dutch reference population (p< 0.001).ConclusionsInjuries of the midfoot have negative effects on mid- to long-term quality of life after trauma, with considerable potential for long-term impaired functionality. When counseling patients with these rare injuries after high-energy trauma mechanisms or in the context of multiple trauma, realistic expectations on postoperative recovery should be given. |
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| Keywords: | Midfoot Chopart Lisfranc Functional outcomes Quality of life High-energy trauma |
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