This is a fracture/injury of the ligaments and bones in the middle part of the foot. This occurs at the level of the metatarsal bones of the forefoot as they connect to the cuneiform bones of the midfoot. Torn ligaments, broken bones can occur during this injury also, it can involve more than one joint.
Lisfranc Injury
Causes
-Twisting injury
-Fall from height
-Crush injury
-Sports injury
-Automobile accident
-Associated with ankle sprain/fractures
Symptoms
-Tenderness at the midfoot
-Inability to walk
-Swelling/Bruising/Blistering midfoot
-Deformity that increases with walking
-Open fracture
Treatment
X-rays/CT/MRI scans may be performed to visualize the fractures and determine the mechanism of injury. This allows the surgeon to come up with a treatment plan
Conservative treatment
This is usually reserved for non-displaced stable fracture patterns with no subluxation/ligamentous injury. Conservative care includes Rest, Ice, Compression, elevation, Below the knee cast, and non-weight bearing to allow for bone healing. The cast and compression may also be done to allow for swelling to go down in preparation for surgical intervention.
Surgical treatment
For displaced fractures with ligamentous injury, surgical repair is warranted. Most lisfranc fractures are treated with ORIF. This allows for the ligament to heal. Primary open reduction internal fixation vs Fusion will depend on the extent of the injury.
Post-op Protocol
NWB for 6 weeks in cast/boot. Then transition to regular shoe gear
