Treatment and Hardware Removal after Lisfranc Injury: A Narrative Review

Lisfranc injuries can be difficult injuries to identify and treat, while also being the subject of significant debate on proper surgical management. A narrative literature review was performed using Pubmed and Google Scholar databases to identify recent studies evaluating open reduction internal fixation vs primary arthrodesis for Lisfranc injuries to further elucidate optimal surgical management. Additional focus was placed removal of hardware after ORIF to identify the need for routine hardware removal as an additional surgery may guide surgeon decision-making. This review showed inconclusive data on the superiority of ORIF vs arthrodesis, as multiple conflicting results exist, though established that functional results are similar between these options. Though both are generally accepted treatment options, there are no well-designed randomized controlled trials directly comparing the two. Retention of hardware after ORIF has been shown to be tolerated, though there is a significant risk of the need for unplanned removal due to pain and hardware breakage.