RESUMO
OBJECTIVE: A retrospective comparison of treatment difficulties and treatment outcomes in Lisfranc joint injuries with late and early diagnosis. METHODS: The study group consisted of 10 patients diagnosed and treated properly within six months to 20 years of the accident causing the injury (mean six years). The control group consisted of the same number of randomly selected patients with a similar type of injury treated immediately after the accident. Mean follow-up was 13 years in the study group and eight years in the control group. The analysis evaluated the causes of the delay and the foot function at the time of follow up, measured using the AOFAS Midfoot Scale and the Lublin Foot Functional Score. The scores of the patients were analyzed using the non-parametric Mann-Whitney U test and the non-parametric Wilcoxon test. RESULTS: The control group had statistically significantly better scores on both scales. CONCLUSION: The main cause of treatment delay was misdiagnosis by the primary care physician. Level of Evidence III, Retrospective Comparative Study .
RESUMO
OBJETIVO: Comparação retrospectiva das dificuldades do tratamento e de seus resultados em lesões na articulação de Lisfranc com diagnóstico tardio e precoce.MÉTODOS: O grupo de estudo consistiu em 10 pacientes diagnosticados e tratados adequadamente em seis meses a 20 anos do acidente que causou a lesão (média de seis anos). O grupo de controle foi composto por igual número de pacientes selecionados randomicamente, com o mesmo tipo de lesão tratada de imediato e após o acidente. A média de acompanhamento foi de 13 anos no grupo de estudo e oito anos no grupo de controle. A análise avaliou as causas do atraso e a função do pé no momento do acompanhamento, medidos pela escala AOFAS para o mediopé e pelo escore funcional do pé de Lublin. Os escores dos pacientes foram analisados utilizando o teste não-paramétrico de Mann-Whitney U e o teste não-paramétrico de Wilcoxon.RESULTADOS: O grupo de controle apresentou resultados melhores com significância estatística em ambas as escalas.CONCLUSÃO: A principal causa de atraso do tratamento foi diagnóstico errado pelo médico de atendimento primário. Nível de Evidência III, Estudo Comparativo Retrospectivo.
OBJECTIVE: A retrospective comparison of treatment difficulties and treatment outcomes in Lisfranc joint injuries with late and early diagnosis.METHODS: The study group consisted of 10 patients diagnosed and treated properly within six months to 20 years of the accident causing the injury (mean six years). The control group consisted of the same number of randomly selected patients with a similar type of injury treated immediately after the accident. Mean follow-up was 13 years in the study group and eight years in the control group. The analysis evaluated the causes of the delay and the foot function at the time of follow up, measured using the AOFAS Midfoot Scale and the Lublin Foot Functional Score. The scores of the patients were analyzed using the non-parametric Mann-Whitney U test and the non-parametric Wilcoxon test.RESULTS: The control group had statistically significantly better scores on both scales.CONCLUSION: The main cause of treatment delay was misdiagnosis by the primary care physician. Level of Evidence III, Retrospective Comparative Study.