Lisfranc Injury

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Sports-Lisfranc.jpgLisfranc joint injuries are one of the most rare and complex injuries and are often misdiagnosed because their symptoms present like other sprains and strains. Lisfranc fractures account for less than 1% of all foot injuries.

Lisfranc injuries occur when the midfoot is twisted when the foot is plantar-flexed, meaning that weight is being placed on the front of the foot, like a ballerina on point.  Lisfranc injuries are not very common outside of sports because of the nature of the injury.

These injuries occur in the joint that connects the toes to the forefoot, however the pain and swelling typically encompasses the midfoot as well.

CAUSES

Lisfranc fractures are generally associated with some sort of trauma, such as a vehicle crash, industrial accident, or high impact pressure to the joint. Occasionally, these injuries result from a less stressful mechanism, such as a twisting fall. Lisfranc joint fracture-dislocations and sprains carry a high risk of chronic repeating breaks until fully healed.

DIAGNOSIS

On physical examination, swelling is found primarily over the midfoot region. Pain is heightened when moving the joints and articulating the toes. If swelling persists longer than 10 days, it is appropriate to seek X-ray, CT Scan or MRI to evaluate the joint. Proper treatment of a mild to moderate Lisfranc injury improves the chance of successful healing and reduces the likelihood of complications.

SYMPTOMS

Pain, swelling and the inability to bear weight and all symptoms of Lisfranc Injury- however the full injury can range from a mild sprain to a fracture-dislocation.

TREATMENT

The recovery time from this injury depends on how severely it was damaged and how much of the joint and foot is encompassed.  If the injury does not require surgery, a cast for 6-8 weeks may be all that is necessary in healing.  After eight weeks a patients can begin to return to normal activities.  If casting the foot does not alleviate the symptoms or re-align the bones, surgically repairing the joint with the aid of small screws and pins for stabilization can be helpful. After casting the foot for 6-8 weeks, patients can begin therapy to strengthen the muscles surrounding the injury, and usually return to normal activities in 3-5 months.