Evidence map›Paper›PMID 41649218›Full record

SynthesisKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2026

Operative treatment of Lisfranc injuries in elite athletes: 2024 International Foot and Ankle Sports Consensus and systematic review.

Julia M Balboni, Arielle Richey Levine, Vanessa J Boggiano, Kassidy J Webber, Scott D Semelsberger, Sebastian Krebsbach, James Butler, M Diane Essis, Brendan Conroy, IFASC Committee and 1 more

Abstract readSystematic ReviewConsensus Statement
In one paragraph

Synthesis in Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Julia M BalboniUniversity of New England College of Osteopathic Medicine, Biddeford, Maine, USA.
Arielle Richey LevineDepartment of Orthopaedics & Rehabilitation, Yale School of Medicine, New Haven, Connecticut, USA.
Vanessa J BoggianoDepartment of Orthopaedics & Rehabilitation, Yale School of Medicine, New Haven, Connecticut, USA.
Kassidy J WebberCommunity Memorial Healthcare, Ventura, California, USA.
Scott D SemelsbergerVirginia Tech Carilion School of Medicine, Roanoke, Virginia, USA.ORCID https://orcid.org/0000-0002-8627-2060
Sebastian KrebsbachDepartment of Orthopaedic Surgery, NYU Langone Health, New York, New York, USA.
James ButlerDepartment of Orthopaedic Surgery, NYU Langone Health, New York, New York, USA.
M Diane EssisDepartment of Orthopaedics & Rehabilitation, Yale School of Medicine, New Haven, Connecticut, USA.
Brendan ConroyCentral Michigan University College of Medicine, Saginaw, Michigan, USA.
IFASC Committee
Arianna L GianakosDepartment of Orthopaedics & Rehabilitation, Yale School of Medicine, New Haven, Connecticut, USA.ORCID https://orcid.org/0000-0002-8362-0752

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeLisfranc injuries are potentially career-threatening for athletes, yet optimal management of unstable ligament and fracture-dislocation injury patterns remains debated. This study integrates an international expert consensus with a systematic review to evaluate current surgical strategies and outcomes, aiming to establish evidence-based recommendations for the treatment of elite athletes and to optimize recovery and return to play.

methodsA systematic review evaluated post-operative outcomes following suture button fixation (SBF), open reduction internal fixation (ORIF) and arthrodesis of unstable ligament and fracture-dislocation Lisfranc injuries. In addition, a consensus process was conducted using a modified Delphi technique. All consensus questions were generated by an initial survey sent to the expert panel. General consensus was defined as 75%-85% agreement, strong consensus as 86%-99% agreement and unanimous consensus as 100% agreement.

resultsSixteen studies (n = 406 athletes) were included. In the unstable ligament group, SBF (n = 46) versus ORIF (n = 203) yielded higher American Orthopaedic Foot and Ankle Society (95.5 vs. 89.4), lower complications (10.9% vs. 18.2%), zero failures (0% vs. 4.9%) and fewer secondary procedures (0% vs. 30.5%), with 93.5% of ORIF reoperations being hardware removal. In fracture-dislocation injury patterns, ORIF (n = 123) and arthrodesis (n = 31) showed similar complication (30.8% vs. 35.5%) and failure rates (13.8% vs. 12.9%), with secondary procedures more frequent after ORIF (90.2% vs. 22.6%). The consensus process generated 16 statements: 12 achieved unanimous agreement and 4 achieved strong consensus.

conclusionElite athletes who present with unstable ligament Lisfranc injuries and indications for surgical intervention should undergo fixation rather than fusion. For bony and fracture-dislocation Lisfranc injuries, ORIF is preferred when joint surfaces are salvageable and arthrodesis when long-term preservation is not feasible. However, the findings of this study underscore the importance of individualized treatment strategies to optimize surgical outcomes and functional recovery. LEVEL OF EVIDENCE: Level V.

Indexed as

Athletic InjuriesFoot InjuriesFracture DislocationLigaments, ArticularArthrodesisAthletesFracture Fixation, InternalHumansJoint DislocationsOpen Fracture ReductionReturn to SportdislocationfractureligamentLisfrancsurgical treatment

Identifiers

PMID41649218
PMCPMC13502415

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.