Is Routine Hardware Removal Following Open Reduction Internal Fixation of Tarsometatarsal Joint Fracture/Dislocation Necessary?

Michael D VanPelt, Alexander Athey, Jie Yao, Kwame Ennin, Layla Kassem, Edward Mulligan, Trapper Lalli, George T Liu

Research output: Contribution to journalArticle

Abstract

Open reduction internal fixation (ORIF) is an accepted treatment for displaced tarsometatarsal joint (TMTJ) fracture dislocations. In general, hardware is routinely removed after 4 months to allow restoration of joint motion and avoid complications of hardware failure. Because few studies report outcomes of TMTJ fractures with retained hardware, there is little consensus regarding the optimal time for hardware removal or if hardware retention leads to adverse outcomes. We retrospectively reviewed the radiographic outcomes of retained hardware after ORIF of TMTJ fractures/dislocations in 61 patients. The mean age at the time of operation was 37.3 ± 14.9 years. ORIF was performed with 3.5 fully threaded cortical screws. Assessment of clinical and radiographic results was performed at 2 weeks, 6 weeks, 3 months, 6 months, and 12 months after surgical treatment. Out of the 61 patients that were included in this study, only 2 demographic variables demonstrated a trend for an adverse outcome. Older age correlated with lost reduction and elevated body mass index correlated with hardware failure. The presence of diabetes was correlated with an increased risk of postoperative infection but not hardware failure. During our follow-up period there were 49 patients (80.3 %) without failure of fixation. In conclusion, our study suggests that routine removal of hardware following open reduction and internal fixation of Lisfranc injuries in patients may not be necessary.

Original languageEnglish (US)
Pages (from-to)226-230
Number of pages5
JournalJournal of Foot and Ankle Surgery
Volume58
Issue number2
DOIs
StatePublished - Mar 1 2019

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Joint Dislocations
Joints
Body Mass Index
Demography
Outcome Assessment (Health Care)
Fracture Dislocation
Wounds and Injuries
Therapeutics
Infection

Keywords

  • 3
  • hardware failure
  • hardware retention
  • Lisfranc fractures
  • open reduction internal fixation
  • tarsometatarsal joint

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

Cite this

Is Routine Hardware Removal Following Open Reduction Internal Fixation of Tarsometatarsal Joint Fracture/Dislocation Necessary? / VanPelt, Michael D; Athey, Alexander; Yao, Jie; Ennin, Kwame; Kassem, Layla; Mulligan, Edward; Lalli, Trapper; Liu, George T.

In: Journal of Foot and Ankle Surgery, Vol. 58, No. 2, 01.03.2019, p. 226-230.

Research output: Contribution to journalArticle

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