![]() Nonsurgical TreatmentĪnyone who has symptoms of a Lisfranc injury should see a foot and ankle surgeon right away. 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. X-rays and other imaging studies may be necessary to fully evaluate the extent of the injury. 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. Lisfranc injuries are sometimes mistaken for ankle sprains, making the diagnostic process very important. Bruising may also occur on the top of the foot. Bruising or blistering on the arch are important signs of a Lisfranc injury.Inability to bear weight (in severe injuries).Pain throughout the midfoot when standing or when pressure is applied.Symptoms of a Lisfranc injury may include: The bones of the Lisfranc joint may be forced from their normal positions. A break in a bone in the Lisfranc joint can be either an avulsion fracture (a small piece of bone is pulled off) or a break through the bone or bones of the midfoot. Therefore, when they are weakened through a sprain (a stretching of the ligament), patients experience instability of the joint in the middle of the foot. The Lisfranc ligament and other ligaments on the bottom of the midfoot are stronger than those on the top of the midfoot. There are three types of Lisfranc injuries, which sometimes occur together: Indirect force commonly involves twisting the foot. A direct force often involves something heavy falling on the foot. Lisfranc injuries occur as a result of direct or indirect forces to the foot. Injuries to the Lisfranc joint most commonly occur in automobile accident victims, military personnel, runners, horseback riders, football players and participants of other contact sports, or something as simple as missing a step on a staircase. This is important for maintaining proper alignment and strength of the joint. The Lisfranc ligament is a tough band of tissue that joins two of these bones. The Lisfranc joint is the point at which the metatarsal bones (long bones that lead up to the toes) and the tarsal bones (bones in the arch) connect. Lisfranc Injuries What Is the Lisfranc Joint? Please enable Javascript in your browser. Although these injuries can vary quite a bit in their severity, good outcomes are often obtained and are an expectation after these injuries, although it can take quite some time to fully recover and return to pre-injury function.Javascript is required to view the content on this page. Surgical treatment involves surgically stabilizing the area and can be accomplished with screw or suture button fixation of the area of instability and, in some instances, even with fusion of the affected joints. More severe injury to the ligament, and any demonstrable instability, often will necessitate surgical treatment. These injuries can frequently be slow to recover to 100%. A sprain of the ligament can often be treated with supportive care, meaning a walking boot for a period of time with a period of transition to a stiff soled shoe. Lisfranc injuries, like many others, come in grades of severity, relating to the degree of injury of the midfoot ligament. The primary ligament of the midfoot, the Lisfranc ligament, is named after Napoleon Bonaparte’s surgeon, as many soldiers on horseback would injure this area if they fell off a horse with their foot stuck in the stirrup. ![]() People will often struggle to push off and change direction, rendering them unable to exercise or play sports. When these ligaments are disrupted the resulting pain and instability can limit a person’s ability to function normally. The bones of the midfoot are somewhat like two square blocks next to one another that rely heavily on their connecting ligaments to maintain stability. Midfoot joints, on the other hand, have very little inherent stability. The ankle, for example, has a high degree of structural stability due to the specific way its bones fit together. Some joints have a lot of inherent stability based on the structure of the bones and tissues of the joint. Lisfranc injuries include ligament strains and tears, as well as fractures and dislocations of bone (far right). The Lisfranc joint complex includes the bones and ligaments that connect the midfoot and forefoot.
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