Are There Any Parameters to Predict the Risk of Screw Breakage Following the Transarticular Screw Fixation in Lisfranc Injuries? A Retrospective Study on 61 Patients

Özet

Objective: The Lisfranc complex is an osseo-ligamentous structure consisting of multiple tarsal and metatarsal bones, joints, and ligaments. The transarticular screw method is the most commonly preferred fixation technique in patients with Lisfranc injury. However, screw breakage complications can be seen with a considerable frequency. Although there are stud- ies in the literature that associate the risk of screw breakage with the diameter or structure of the screw used, there is still no consensus. The aim of this study is to predict the risk of screw breakage by examining many parameters. Methods: We retrospectively evaluated 61 patients with lisfranc injuries who underwent transarticular fixation with screws of different diameters and properties. We found screw breakage complications in 9 (14.7%) of the patients. Some demographic and radiological parameters were examined to predict screw breakage in these patients. Age, gender, weight, diameter and structure of the screw used, presence of accompanying cuneiform, cuboid or metatarsal base fracture, how many tarsometatarsal joints were involved and whether anatomical reduction was achieved. In addition, the development of post-traumatic arthro- sis during the 2-year follow-up, and the American Orthopedic Foot and Ankle Association (AOFAS) -Middle Foot Score and Visual Analogue Scale (VAS) scores were also compared in clinical evaluations. Results: We could not find any radiological or demographic parameter that could predict the screw breakage complication in the results. We found only that post-traumatic arthritis was significantly more common in patients with screw breakages. We also found that there was no significant difference in AOFAS-midfoot and VAS scores in patients with or without screw breakage complications. Conclusion: In the transarticular screw fixation of Lisfranc injury; screw’s diameter, can- nulated or solid structure, the presence of accompanying tarsal or metatarsal injuries and the reduction quality of the injured anatomic structures do not pose any risk factors for the screw breakage complication.