Fixation Insitu Versus Removal for Midfoot Lisfranc Injuries

Inclusion Criteria: * Subject has Lisfranc injury that was treated within 28 days of injury. * Subject must be enrolled in study between 6 and 8 weeks from time of initial fixation operation. * The patient must be medically fit for anesthesia * Subject is willing and able to provide written informed consent for trial participation * Subject is willing and able to comply with the study protocol including return for all follow-up evaluations * Subject may have a bony, ligamentous, or combined lisfranc injury * Demonstrated instability of the lisfranc complex on static, stress view or CT radiography. * Associated injuries - other than the lisfranc complex - are permitted provided those injuries are not deemed to significantly influence the rehabilitation or recovery of the patient at the discretion of the enrolling surgeon * Adequate reduction to within 1mm of lisfranc complex at time of fixation * Hardware across the midfoot (tarsal-metatarsal joints 1-3) Exclusion Criteria: * Subject has a significant pre-existing foot injury * Subject has a delay in initial treatment greater than 28 days from time of injury * Subject has an active infection in the area of surgical approach requiring surgical debridement * Subject has concomitant injury which, in the opinion of the attending surgeon, is likely to impair rehabilitation or prolong fracture healing time (another long bone fracture, ipsilateral limb injury) * Subject has a history of rheumatoid arthritis, Diabetes, fibrous dysplasia, chronic renal failure, Paget's disease, or osteopetrosis or any other pre-existing pathologic condition affecting the Lisfranc complex * Subject has a high risk of death from surgery (ASA physical status Class V) * Subject is likely unable to maintain follow-up(no fixed address, plans to move out of town in the next year, states unable to comply with protocol, etc.) * Subject has cognitive impairment or language difficulties that would impede the valid completion of questionnaires * Subject is pregnant * There has been loss of fixation or reduction prior to enrollment * Previous corrective foot surgery * Associated fracture of calcaneus, talus, or tibial plafond. * Pathologic fracture * Loss of fixation or reduction prior to enrollment