Sometimes when your feet hurt, you may not know exactly why. Often confused with a simple sprain, Lisfranc injuries can be quite severe and take many months to heal. These injuries happen in the midfoot, an area which is essential for absorbing the forces that accompany walking, running, and jumping.
Basic Foot Anatomy
In order to better understand Lisfranc injuries, it can be helpful to know a bit about the basic structure of the foot. The Lisfranc joint complex is comprised of the ligaments and bones that connect the forefoot and midfoot.
The midfoot stabilizes the foot arch with the use of the tarsal bones. The forefoot contains the metatarsal bones, which lead up to the toes. The tarsal and metatarsal bones are connected by the Lisfranc ligament complex. These tough bands of tissue maintain proper bone alignment and provide strength to the joint.
Lisfranc Injury Symptoms and Causes
The primary signs and symptoms of a Lisfranc injury are swelling in the top of the foot, bruising on the bottom (and also top in some cases), and pain that becomes progressively worse when walking or standing.
These injuries can happen from either indirect or direct forces to the affected foot. Many cases occur as the result of falling or twisting the foot, especially in sports like football and soccer. A common situation that results in the injury is when an athlete’s planted foot is flexed in a downwards position and he or she stumbles over the top of it. Direct trauma, like a fall from a height, can also lead to multiple dislocations and fractures in the Lisfranc joints.
Types of Lisfranc Injuries
There are essentially three different types of injuries in this area, and they can happen independently or as a combination. These types of injuries are:
- Sprains – When any of the ligaments in the Lisfranc complex become strained, it results in instability in the joint.
- Fractures – There are various ways that the bones in the complex can become broken, including avulsion fractures or outright breaks.
- Dislocations – In some cases, the bones are forced out of their intended positions.
Treating Lisfranc Injuries with Conservative Methods
The immediate first aid and treatment for a Lisfranc injury is to use rest, ice, and elevation to protect the injury and reduce swelling and pain. Further treatment options that we may recommend include immobilization, oral medication, or physical therapy. To immobilize the injury, we may need to place the affected foot in a cast and issue crutches to keep weight off it.
Lisfranc Surgery and Recovery
Depending on the nature and severity of the injury, surgery may become a necessary part of treatment. The surgical procedures that can be used are internal fixation and fusion. For internal fixation, bones are placed in their intended locations and secured with screws or plates. At a later date, approximately 3 to 5 months afterwards, the screws or plates are removed to restore movement.
Fusion is more likely to be used in severe cases that are damaged beyond other repair. The object of this procedure is to fuse damaged bones together so they can heal into a solid, single piece. If screws or plates are used in a fusion procedure, they will likely not need to be removed on account of the joints being fused together.
Following a 6 to 8 week period after the surgery, we will use x-rays to determine if weight bearing can begin. If so, our foot doctors will determine the extent of acceptable weight bearing and use this information to determine the course of rehabilitation.
Effective Lisfranc Injury Treatment in Austin, TXWhether through the use of conservative or surgical methods, you will receive the first-class treatment you need for your Lisfranc injury here at Austin Foot and Ankle Specialists. Our expert foot doctors—Dr. Craig H. Thomajan DPM, FACFAS and Dr. Shine John, DPM, FACFAS—have the skill, experience, and knowledge to develop the right treatment plan for your unique situation. Schedule your appointment with our Austin, TX office today online or simply give us a call at (512) 328-8900.