A Lisfranc injury typically occurs when the foot is twisted during a fall or when a weight lands on the foot while it is flexed downward. The injury is most often seen in horseback riders, athletes participating in contact sports, runners, and accident victims. The most common symptoms of a Lisfranc injury include:
• Pain and swelling in the foot (the pain is often worse when standing or walking)
• Bruising along the top and bottom of the foot
Diagnosing a Lisfranc Injury
A Lisfranc injury is often misdiagnosed as a simple sprain. If the standard rest, ice, compression, and elevation therapy does not relieve your pain and swelling, you should see a foot doctor for further evaluation. During the physical exam, the doctor will perform several tests to determine if you have pain with certain movements that would indicate a Lisfranc injury. X-rays, MRIs, and CTs may also be used to determine the extent of your injury.
Treatment of a Lisfranc Injury
A variety of surgical and non-surgical options are available to treat Lisfranc injuries. If the injury is stable, the patient is typically placed in a non-weightbearing cast or boot for at least six weeks. During this time, the doctor will order follow-up tests to ensure that the foot is healing properly. Unstable injuries involving fractures or subluxation may require surgery. The surgery involves using plates, screws, or other hardware to realign and hold joints in place.
Rehabilitation and Recovery
Patients are typically required to be non-weightbearing for six to eight weeks following surgery for a Lisfranc injury. After about eight weeks, the patient is allowed to gradually add weightbearing activity under the direction of their surgeon or physical therapist. High-impact activities, such as jumping and running, should be avoided until the hardware is removed.
A Lisfranc injury can be very serious, especially for high-level athletes. It is not uncommon for individuals with this type of injury to experience chronic pain or to develop arthritis in the affected joint. With excellent treatment and therapy, some athletes are able to return to their pre-injury level of performance.