Lisfranc Injury Treatment [Exercises, Rehab & FASTER Recovery Time]

What is a Lisfranc injury?

A Lisfranc joint injury is a type of injury to the bones, ligaments, or both, in the middle of your foot. In a Lisfranc joint injury, there is usually damage to the cartilage covering these bones.

A cluster of small bones forms an arch in the middle region of your foot (midfoot). Five of these long bones (the metatarsals) extend to the toes. The group also includes smaller bones: the cuboid bone and the medial, middle, and lateral cuneiform bones. Tight connective tissue bands hold these bones in place and give the joint its stability. This area of the foot is important in stabilizing your arch and transferring the force from your calves to the front of your feet.

A twisting fall may break one or more of these bones or shift the bones out of place, causing a Lisfranc injury (tarsometatarsal joint injury). The injury comes from a French surgeon, Jacques Lisfranc de St. Martin. There are different categories of Lisfranc injuries, depending on the direction of the displaced metatarsals and their degree of displacement.

Lisfranc joint injuries are somewhat uncommon. These injuries can vary from simple to complex, depending on the number of bones involved and the degree of disruption.

Lisfranc Injury Causes:

Lisfranc joint injuries occur from trauma to the foot. This may happen with a simple twist and fall on top of a foot that is pointing downward. It is common in football and soccer players. Lisfranc injuries can also happen from direct trauma, like a fall or a motor vehicle accident. Such an injury is more likely to result in a more severe injury with multiple fractures and dislocations of the midfoot bones.

What are the symptoms of a Lisfranc joint injury?

A Lisfranc joint injury might cause symptoms like the following:

• Pain in your midfoot, especially sore to the touch
• Swelling or deformity in the middle region of your foot
• Inability to put weight on your foot
• Bruising in the middle of your foot
• The intensity of these symptoms may vary according to the severity of your injury and how long ago it happened.

How is a Lisfranc joint injury diagnosed?

Your healthcare provider will begin with a health history, asking questions about your recent symptoms and your past medical problems. Your healthcare provider will also examine your foot, looking for tenderness, deformity, bruising, and swelling. Your healthcare provider may grasp your toes and move them up and down, seeing whether this causes pain.

To definitively diagnose your Lisfranc injury, your healthcare provider will order X-rays. Your healthcare provider might need to order special foot views, as these injuries sometimes don’t appear on standard X-rays.

Sometimes, your healthcare provider might order more detailed imaging to get more information about your foot. MRI gives more information about damage to the soft tissues in your foot. CT scans give more detailed information about damage to your bones. These tests may pick up injuries that an X-ray alone might miss. It is important to diagnose your injury correctly because the treatment for a simple ankle sprain (a common misdiagnosis) is quite different. An emergency room healthcare provider typically makes the diagnosis. But an orthopedic specialist might help treat you.

Lisfranc injury treatment:

Your treatment may vary based on the severity of your injury. You may need only nonsurgical treatment for your injury if you don’t have any bone breaks, if your bones are still in alignment, and if your ligaments are not completely torn. For these types of injuries, your treatment might include:

• Taking pain medicines
• Wearing a non-weight-bearing cast or boot for six weeks
• Wearing a weight-bearing cast or special foot support after the first six weeks
• Having serial X-rays to find out how your foot is healing
• It is important not to put weight on your foot during the initial healing period.

If your injury is more severe than this, you probably would need surgery as well. Your healthcare provider may do a surgery called open reduction and internal fixation. During this surgery, they put your bones back in the correct alignment. Using special metal plates and screws, your surgeon physically attaches the pieces of your bones back together. Your surgeon might remove some or all of this hardware later. They might also repair other ligament injuries.

Joint fusion surgery for a Lisfranc injury:

Less commonly, the surgeon does a joint fusion as the initial procedure. This surgery permanently fuses one or more of the bones in the region so they heal into a single, solid piece. Surgeons usually only do this if the damage is very severe and they cannot repair it.

After either surgery, you must use a splint or cast for several weeks. You should not put weight on your foot during this time.

Can go wrong with a Lisfranc injury?

Lisfranc joint injuries often cause arthritis in the injured bones of your foot.  In fact this is the most common outcome according to studies. This might cause chronic pain in the region. You are more likely to develop arthritis if you have a severe Lisfranc joint injury that damages much of the cartilage in the region.

Is a Lisfranc injury surgery usually successful?

This arthritis might develop even if your initial surgery was successful.

Some people need to have joint fusion surgery to relieve these symptoms if their arthritis is severe.

There is also a risk that your bones will fail to heal properly. This might require follow-up surgery. These risks may be higher if you smoke and have certain health conditions such as diabetes or osteoporosis.

When should I call my podiatrist?

Call your surgeon if you have a high fever or chills, if the pain increases, or if your foot feels numb.

In fact if you are 1 of our patients he can give us a call and we love to take care of you. 1 the most common problems we see are tight stiff joints osteoarthritis and osteo-porosis in the middle of the foot from disuse due to problems.

What are the most common problems even after surgery from a Lisfranc joint?

A Lisfranc joint injury is a type of injury to the bones or ligaments in the middle part of your foot, the tarsometatarsal joint. It can range from mild to severe.

Your Lisfranc joint injury might cause bruising, deformity, swelling, or pain in the middle of your foot. Your foot will likely also be unable to bear weight.

Your podiatrist can diagnose your injury with a medical history, a physical exam, and the use of imaging tests.

If your injury is mild, you might only need treatment with casts or boots and pain medicines.

If your injury is more severe, you will probably need surgery.

Sometimes, Lisfranc joint injuries result in long-term arthritis of the bones of your foot.