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Table 2 GRADE assessment

From: Inconsistent radiographic diagnostic criteria for lisfranc injuries: a systematic review

Quality of evidence assessment

No. of patients diagnosed (% total injuries)

Overall quality of evidence

Importance

No. of studies

Study design

Risk of bias

Inconsistency

Indirectness

Imprecision

Other considerations

M1-M2 diastasis

 18

Case series, Retrospective

Moderate

Seriousa

Not serious

Not serious

None

468 (42.0)

Moderate

Important

C2-M2 subluxation

 11

Case series, Retrospective

Moderate

Not serious

Not serious

Not serious

None

562 (50.4)

High

Critical

C1-M2 diastasis

 8

Case series, Retrospective

Moderate

Seriousa

Not serious

Not serious

None

377 (33.8)

Moderate

Moderate

C3-M3 subluxation

 7

Case series, Retrospective

Moderate

Not serious

Not serious

Not serious

None

372 (33.3)

Moderate

Moderate

Longitudinal arch height

 7

Case series, Retrospective

Moderate

Not serious

Not serious

Not serious

None

297 (26.6)

Low

Low

Cuboid-M4 subluxation

 7

Case series, Retrospective

Moderate

Not serious

Not serious

Not serious

None

392 (35.2)

Moderate

Moderate

Talometatarsal angle

 7

Case series, Retrospective

Moderate

Not serious

Not serious

Not serious

None

260 (23.3)

Low

Low

Medial column malalignment (C1-M1)

 6

Case series, Retrospective

Moderate

Not serious

Not serious

Not serious

None

397 (35.6)

Moderate

Moderate

Cuneiform-metatarsal malalignment

 6

Case series, Retrospective

Moderate

Not serious

Not serious

Not serious

None

345 (30.9)

Moderate

Moderate

Fleck sign

 6

Case series, Retrospective

Moderate

Seriousb

Not serious

Not serious

None

110 (9.87)

Very low

Low

Notch sign

 1

Retrospective

Low

Not serious

Not serious

Not serious

None

36 (3.22)

Very low

Low

  1. aInconsistent measurement thresholds used across different studies for the same radiographic diagnostic criteria
  2. bWithin individual studies, some patients with Lisfranc injuries showed Fleck signs while others did not