Lisfranc dislocations - ORIF vs fusion - Debate 

Having lived it, as an average non elite nurse... arthrodesis all the way. I feel the argument for ORIF neglects a bigger picture, the rest of the parient and their life! I was primarily ligamentous, very minor, and took 2 months to see foot ortho so we went non surgical route. It took six months before I was just barely walking in shoes. 6 months, of my 39th year. But it failed, the remaining bits of ligament snapped. It was felt the only option was fusion. But covid. So i had to wait for another 6 months to have surgery. 18 months postop, I'm still in PT. Trying to go back to school so i can do something off my feet. I was 39 at the time of injury. I'll likely be 44 by the time my life will be normal. I spent over 18 months, the last of my thirties unable to drive, on crutches in a boot, not able to go to the beach, alone in a 2nd story apartment living on Door Dash and gaining 20 lbs. Yeah, my situation was complicated by covid, but the timeline might actually have been more drawn out with a failed ORIF immediately post injury in the best of circumstances. And even a successful ORIF or non surgical success... i had a pretty high likelihood of developing arthritis in 10 years, at age 50 and hopefully still otherwise healthy. Yes, i will have chronic pain with my fusion, but its liveable. And some chronic pain is just kind of inevitable with this injury. You cant underestimate how painful foot surgery is. Like forgetting the years of your life wasted, the first 2 weeks pain is a hell i wouldnt repeat for $1M. I like knowing my foot is totally solid and stable, and there's not going to be another surgery. I'm doing more than i thought I'd be able to do again. If I had been offered ORIF right away, I'd have gone for it. Knowing what I know now? No way. Unless you are that elite athlete with elite daily PT and surgery immediarely after PT and really need that 3.5% mobility, no. Just get the fusion done asap and move on with your life. You don't understand the risks until you live them. If i were that middle aged accountant, id probably have wanted an ORIF, and then been one of those unsatisfied patients a year later. Doing definitively whats in the patients best interest is so the way to go. I find it slightly troubling that orif won by such a large margin. I guess for the 30 yo its fair to offer both but... you really need to give a realistic picture of the long term. Like, thats an age many women want to be having kids and chasing them around. Spend a couple years going thru 3 surgeries, delay starting family... I wish docs knew what lisfranc patients talk about in support groups. They're all so different, so complicated, and and totally changing, and it involves way more than just the foot.

Thanks but “has a roll” should be “has a role”

What was the time length between the occurrence of the injury and when the surgery was performed.

Necesito escuchar en español, tuve un accidente y me operaron de Lisfranc