NCT05799807

Weight-bearing Diagnostics in Acute Lisfranc Injury: CT vs X-ray

Weight-bearing Diagnostics in Acute Lisfranc Injury: A Prospective Study Comparing Computed Tomography Versus Conventional Radiography

• Status: Active Not Recruiting
• Phase: N/A
• Study type: Interventional
• Enrollment: 38 (actual)
• Sponsor: Oslo University Hospital · Academic / Other
• Sex: All
• Age: 18 Years – 70 Years
• Healthy volunteers: Accepted

Summary

A prospective, cohort study comparing weight-bearing computed tomography with weight-bearing radiography in patients with an acute Lisfranc injury.

Detailed description

Injury to the tarsometatarsal (TMT) joint complex in the midfoot is referred to as a Lisfranc injury. The broad spectrum of these injuries includes simple sprains to severe fracture-dislocations. Variable clinical presentations and radiographic findings make Lisfranc injuries notoriously difficult to detect, especially in the case of subtle ligament injuries. Nowadays, up to 30% of unstable Lisfranc injuries are overlooked or misdiagnosed. This can potentially lead to severe sequelae such as post-traumatic osteoarthritis and foot deformities. For obvious injuries involving diastasis, subluxation, or dislocation, the diagnosis is relatively easy to establish using any imaging modality. However, for subtle injuries without gross bone separation, a dynamic imaging modality facilitating weight-bearing are to be preferred. Many consider weight-bearing conventional radiography as the current gold standard in acute Lisfranc injury diagnostics. However, conventional radiography is a 2D technique that can neither display nor measure the true dimensions of a detailed 3D object, such as the tarsal bones in the foot. Computed tomography (CT) provides greater accuracy in visualizing bone microarchitecture. In combination with weight-bearing, it can be ideal for detecting minor fractures and occult instability caused by load/stress. To this day, there are no prospective studies comparing weight-bearing CT and weight-bearing radiography for acute Lisfranc injuries. In the current study, participants will be assigned to non-operative or operative treatment based on Lisfranc joint stability evaluation by the initial weight-bearing CT.

Conditions

• Lisfranc Injury
• Foot Sprain

Interventions

Type	Name	Description
PROCEDURE	Conservative treatment	Patients with negativ weight-bearing CT will be treated conservative
PROCEDURE	Minimally invasive stabilization	Patients with positive weight-bearing CT will be operated by minimally invasive stabilization (eg, isolated homerun screw)

Timeline

• Start date: 2023-04-18
• Primary completion: 2024-04-30
• Completion: 2025-06-30
• First posted: 2023-04-05
• Last updated: 2024-06-27

Locations

1 site across 1 country: Norway