Return to sport following Lisfranc injuries in elite athletes-2024 International Foot and Ankle Sports Consensus and systematic review
Abstract
Purpose: Lisfranc injuries, also referred to as tarsometatarsal joint injuries, are relatively uncommon within the general population and can possess profound clinical implications, especially for elite athletes. Existing follow-up and return to sport (RTS) protocols remain poorly defined and variable based on surgeon preference or institutional protocols. The purpose of this study was to both perform a systematic review and determine if consensus on postoperative protocols and RTS timelines could be reached among an expert panel of orthopaedic foot and ankle surgeons who manage Lisfranc injuries in the elite athlete.
Methods: The systematic review evaluated the post-operative management of sports-related Lisfranc injuries. A consensus process was then conducted using a modified Delphi technique with four rounds of questionnaires. General consensus was defined as 75%-85% agreement, strong consensus as 86%-99% agreement and unanimous consensus as 100% agreement.
Results: The systematic review found patients with ligament Lisfranc injuries were permitted to begin weightbearing at an average of 3.5 weeks. The mean time for these athletes to RTS was 8.9 months. Those with bony Lisfranc injuries were allowed to partially weightbear at 4.5 weeks, on average. Bony Lisfranc injuries treated with open reduction and internal fixation (ORIF) allowed the athlete to RTSs at a median of 8 weeks (range 3-12 weeks). There are nine consensus statements presented that illustrate the expected…
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