A Lisfranc injury is a traumatic injury to the midfoot at the location of the Lisfranc, or tarsometatarsal joint. This type of injury may vary in severity, and may involve a sprain, a torn ligament, a fracture or a dislocation. Such injuries have a number of possible causes, including a sports injury or automobile accident. Lisfranc injuries generally involve some sort of crushing blow to the foot or twisting of the foot.
Lisfranc injuries, which are relatively rare, are often misdiagnosed as simple sprains, especially if the injury is sustained as a result of a forward twist or fall. Common symptoms of a Lisfranc injury include pain, swelling and bruising under the sole of the foot, as well as difficulty standing or walking. When such symptoms present, it is important to seek immediate medical care because of the potential difficulty in diagnosing the condition and the possibility that, without prompt treatment, proper healing may not take place.
The Lisfranc joint and the injury are named for the Napoleonic field surgeon who tended a soldier with a severe injury to that region. Treatment for a Lisfranc injury depends on the severity of the condition, but may include conservative measures such as immobilizing the foot or casting. If the joints of the midfoot are malaligned, however, Lisfranc surgery will generally be necessary.
Diagnosis of a Lisfranc Injury
Lisfranc injuries are first suspected when there is severe pain or swelling in the midfoot region, and the patient has difficulty to put weight on the foot. In some cases, a Lisfranc injury takes place in conjunction with the fracture of another small bone in the foot, so when foot injuries occur, it is important that the entire foot be carefully examined.
These injuries are diagnosed through a physical examination. Imaging exams such as standing X-rays or CT scans are also taken to confirm the type of Lisfranc injury, its precise location and severity.
Fixation of lisfranc injury
Surgery for a Lisfranc injury is recommended when a fracture or ligament tear has occurred within the midfoot or when the joints have moved into a malaligned position. The primary goals of Lisfranc injury fixation are to realign the joints of the midfoot. Fixation devices including plates, screws, or wires may be used to secure the placement of the joints and promote stability in the foot until the healing is complete. The hardware may be removed a few months after the procedure, or it may remain in the foot permanently.
Recovery from fixation of Lisfranc Injury
Following Lisfranc surgery, patients typically need to be non weight bearing for six to eight weeks. Wearing an arch support may also be necessary for up to year after surgery. Physical therapy is often an important part of the recovery process as it can help restore proper function and strength to the foot as it heals.
Results of Fixation of lisfranc injury
Some athletes who undergo Lisfranc injury fixation may never be able to return to their pre-injury performance levels. Patients may be more likely to develop arthritis in the future, due to cartilage damage following the surgery. If arthritis does develop, an additional surgery to fuse the bones together may be necessary. While the results vary based on a number of factors, most patients experience a positive outcome that allows them to return to an active lifestyle.