Lisfranc Injuries

When we think about severe foot injuries, the bones of the ankle usually come to mind first. However, there is a complex joint in the middle of the foot that is just as important to maintain the proper function of your feet, and it is called the Lisfranc joint. This joint is found where the long bones that lead up to the toes connect with the bones in the arch. There is a tough band of tissue called the Lisfranc ligament connecting two of these bones, and it is important for maintaining proper alignment and strength of the joint.

Lisfranc injuries occur as a result of direct or indirect forces to the foot. For instance, a direct force often involves something heavy falling on the foot while an indirect force commonly involves twisting the foot. Injuries to this joint are common among military personnel, automobile accident victims, runners, horseback riders, football players, and participants of other contact sports. Something as simple as missing a step on a staircase can also result in a Lisfranc injury.

There are three types of Lisfranc injuries, which may occur together – sprains, fractures, and dislocations. Sprains refer to the stretching of the Lisfranc ligament which can lead to instability of the joint in the middle of the foot. Fractures can happen through bones of the midfoot, or an avulsion fracture where a small piece of bone is pulled off. Finally, dislocations occur when the bones of the Lisfranc joint are forced from their normal positions.

Symptoms of a Lisfranc injury can vary but usually include swelling, pain throughout the midfoot when standing or when pressure is applied, inability to bear weight (in severe injuries), bruising, or blistering on the arch. Any abnormal widening of the foot should be investigated, and people who have symptoms of a Lisfranc injury should see a foot and ankle surgeon right away. If you think you have a Lisfranc injury, consider seeing Dr. Gilbert Huang DPM.

Lisfranc injuries can sometimes be mistaken for ankle sprains, making diagnosis a crucial process. To arrive at a diagnosis, the foot and ankle surgeon will ask questions about how the injury occurred and will examine the foot to determine the severity of the injury. X-rays and other imaging studies may be necessary to fully evaluate the extent of the injury. The surgeon may also perform an additional examination while the patient is under anesthesia to further evaluate a fracture or weakening of the joint and surrounding bones.

Treatment for Lisfranc injuries usually involves immobilization, oral medications such as nonsteroidal anti-inflammatory drugs (NSAIDs) to reduce pain and inflammation, ice and elevation to control swelling, and physical therapy after the swelling and pain have subsided. However, some types of Lisfranc injuries require surgery, and the foot and ankle surgeon will determine the type of procedure that is best suited to the individual patient. Some injuries of this type may require emergency surgery.

Complications of Lisfranc injuries can and often do arise. For instance, there is a possibility of experiencing compartment syndrome whereby pressure builds up within the foot tissues, requiring immediate surgery to prevent tissue damage. A build-up of pressure could damage the nerves, blood vessels, and muscles in the foot. Also, arthritis and problems with foot alignment are very likely to develop. In most cases, arthritis develops several months or longer following a Lisfranc injury, requiring additional treatment.

In conclusion, while Lisfranc injuries are not as common as other foot injuries, they can be very serious and have long-term impacts on a patient’s life. It is essential for people with any possible symptoms of Lisfranc injuries to visit a foot and ankle surgeon right away for an accurate diagnosis and treatment.