lisfranc injury

Lisfranc Injury: Importance of Correct Diagnosis

What happens if a Lisfranc injury is misdiagnosed and does not get correctly treated?

There’s a good chance that you have never heard of a Lisfranc injury. The exception to that would be those who are big sports fans, especially football fans.

The list of football players who have had their seasons’ end due to this rather rare injury to the midfoot area of the foot may not be as long as those who have suffered torn ACLs, fractured bones, severe concussions, and spinal injuries. While a Lisfranc injury may not warrant coverage in the sports section of our local newspaper for most people, it can be very serious. This is particularly true if it is not correctly diagnosed, which happens more often than we would like to think due to its being mistaken for a simple sprain. 

What Is a Lisfranc Injury?

A Lisfranc injury occurs in the midfoot, which is the middle region of the foot. Playing a very important role in how the foot moves, especially while walking, the midfoot is made up of a group of small bones. These bones are what create the arch on the top of the foot. Along with this collection of small bones, which are involved in the transfer of energy from the forefoot to the calf muscles, there is a joint connecting the midfoot to the forefoot. This is the tarsometatarsal joint, which is commonly referred to as the Lisfranc joint, named for the 19th-century French surgeon, Jacques Lisfranc de St. Martin. 

It is not uncommon to suffer injuries to the feet or ankles. Hearing that someone has sprained an ankle may elicit a bit of sympathy if you know how painful it can initially be, but most people have experienced the same thing at one time or another and have healed with an icepack and some rest. 

Sprains involve damage to a ligament, but an injury to the Lisfranc joint is more than a simple sprain and can include not only damage to the midfoot ligaments but also breaks in one or more of the midfoot bones. 

With a sprain, there will usually be someone who tries to be helpful and tells you to “just walk it off”. This isn’t even good advice for a simple sprain, which needs rest, icing, compression and elevation. With a Lisfranc injury, this same type of conservative treatment may be sufficient, if it is a very mild injury. Unfortunately, there is often more severe damage, including torn ligaments and broken bones that go undetected due to the belief it is only a sprain. 

A Lisfranc injury can be quite serious. When not correctly diagnosed and treated, it has the potential to lead to chronic and often debilitating pain. With proper diagnosis and treatment, there is still a good chance that a Lisfranc injury will eventually result in the development of posttraumatic arthritis in the midfoot joint. Without treatment, the risk is even greater. 

As with other orthopedic injuries, the earlier medical care is sought, the better your chances for a more successful outcome.

If you have questions about a Lisfranc injury or about any other foot or ankle concerns, Dr. Christopher Hubbard is a board-certified Orthopedic Surgeon with Ortho-Care Wayne in Passaic County New Jersey and is the former Chief of the Foot and Ankle Service at Mount Sinai Beth Israel in NYC.

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