Comparison Between Allogeneic Tendon Fixation and Screw Fixation in Ligamentous Lisfranc Injury: a Biomechanical Analysis

Objective To compare the stability provided by a allogeneic tendon with a screw for the treatment of ligamentous Lisfranc injury. Methods Six fresh-frozen, paired cadaveric feet were loaded in the condition of Lisfranc ligament intact, injury and fixation models. With axial or abduction stress, the distance between medial cuneiform and second metatarsal was recorded. Results With both two types of stress, there were statistically significant differences in motion detected between the intact and post-injury conditions (all P=0.000), and the magnitudes were greater with abduction [(4.14±1.02) mm] than axial load [(1.60±0.64) mm]. In screw fixation group, the mean position changes under axial load and abduction load were (1.53±0.62) mm and (4.06±1.05) mm in post-injury model respectively, while the changes were (0.76±0.35) mm and (1.20±0.53) mm in the fixation model (all P=0.000) which were not statistical different to that in the intact model. In allogeneic tendon fixation group, the mean position changes were (1.66±0.65) mm and (4.21±1.00) mm in the post-injury model, while were (0.90±0.41) mm and (1.33±0.61) mm in the fixation model (all P=0.000) which also were not statistical different to that in the intact model. Conclusion Under abduction stress, a significantly greater difference was found between pre- and post-injury, which may be valuable for diagnosing and testing ligamentous Lisfranc injury. Allogeneic tendon fixation can provide similar stability as screw fixation in ligamentous Lisfranc injury.