D3 | Abstract 10

Annual NUTRIM Symposium 18 November 2020

FUNDAMENTAL SCIENCE

The BFF Study- The Better to Fix or Fuse Study

G.A.N.L. Stollenwerck MD1, N. van den Boom MD2,3, M. Poeze, MD PhD2,3, P. Schormans MD5, T. Schepers MD PhD6, J.M. Hoogendoorn MD PhD7, E. Hermans MD PhD8, R. van Vugt MD PhD9, H. Janzing MD PhD10, S. Evers PhD3,11

1 Department of Surgery, Alrijne Hospital Leiderdorp, Leiderdorp, The Netherlands
2 Department of Surgery, Maastricht University Medical Center +, Maastricht, The Netherlands
3 NUTRIM, School for Nutrition, Toxicology and Metabolism, Maastricht University, Maastricht, The Netherlands
4 Department of Surgery, University Medical Center Groningen, The Netherlands
5 Department of Surgery, Amphia Hospital, Breda, The Netherlands
6 Department of Surgery, Amsterdam Medical Center, Amsterdam, The Netherlands
7 Department of Surgery, Haaglanden Medical Center +, Den Haag, The Netherlands
8 Department of Surgery, Radboud University Medical Center, Nijmegen, The Netherlands
9 Department of Surgery, Zuyderland Medical Center, Heerlen, The Netherlands
10 Department of Surgery, Viecuri Medical Center, Venlo, The Netherlands
11 Trimbos Institute, Netherlands Institute of Mental Health and Addiction, the Netherlands
Background:
The Lisfranc injury is a complex injury of the midfoot. It can result in persistent pain and functional impairment if treated inappropriately. Treatment options are primary arthrodesis of the midfoot joints or open reduction and internal fixation with retaining of the midfoot joints. Literature indicates that both treatment options from the study are accepted. The decision of which treatment option will be used is up to the surgeon and often based on expertise. No clear advantage for one treatment option is found at present in the literature. 

Objective: 
This Dutch prospective multicenter interventional aim to define the optimal treatment for Lisfranc fracture-dislocation, regarding the quality of life, complications, functional outcomes, and cost-effectiveness. 

Methods: 
This study aims to include 112 patients in 2 years undergoing surgery for Lisfranc fracture-dislocation. Patients will be eligible for inclusion if over the age of 18 years with an acute (<6 weeks) traumatic fracture-dislocation in the Lisfranc midfoot joints, displaced or unstable, and eligible for either one of the surgical procedures. Included patients will be randomly allocated to one of the two surgical procedures due to a computer-based randomization procedure. The follow-up period will be 2 years. 
The primary outcome is the quality of life. Secondary outcomes are complications, functional outcomes, and cost-effectiveness. We will measure these outcomes by online questionnaires, radiographs, and clinical follow. 

Results: 
This study has been open for inclusion since July 2020.

Conclusion:
We expect patients have a better quality of life and less complications after primary arthrodesis compared to open reduction and internal fixation. Additionally, we expect this approach to be more cost-effective, as patients will be less exposed to reinterventions.
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