In severe injuries unfortunately the damage can lead to wear and tear in the joints even after surgery. The metalwork can be prominent on the foot and removed, in fact many surgeons take the metal out as routine after 4 months. Return to full activity can take over 5 months, whether an amateur or a professional athlete. Initial plaster casting is worn for 6 weeks and then depending on the severity of injury a boot may be required for a further 6 weeks. Long-term insoles, especially in sports can be worn to good effect after initial treatment. In the less severe or stable fractures, where on scans the bones are in their normal anatomical positions, they can be treated non-operatively with non-weight bearing in a plaster or boot for about 6 weeks. If the bones heal in the wrong position chronic foot pain and arthritis at the Lisfranc joint can be a future problem. Operative treatment fixing with plates or screws on the top of the foot is usually advocated for more severe or unstable injuries, where the bones have moved apart form their normal position at the level of the Lisfranc joint. How is a Lisfranc fracture normally treated? Often a CT (computerised tomography) is done also to further assess the fracture or injury pattern. How is a Lisfranc injury accurately diagnosed?Īn accurate clinical assessment by an Orthopaedic foot and ankle surgeon is vital. Referral for urgent and accurate clinical assessment with an X-Ray is important. If in doubt as to whether you have this injury you are advised to keep your foot elevated and avoid walking on it if possible. What should you do if you suspect an injury? Bruising can become rapidly apparent on the foot. It is usually very uncomfortable to walk on the foot. The middle of the foot can swell quite dramatically. They can occur due to crush injury on the foot or trapping part of the foot while the rest of the foot twists. They are increasingly seen in athletes with forced twisting or crush injuries but can even occur from a simple stumble on uneven ground or slip of a step. Virtually any mechanism can lead to this fracture. Thankfully the modern Lisfranc fracture is nothing to do with an amputation! What sort of accident or injury can cause a LisFranc fracture? It is so-called because Jacques Lisfranc de St Martin, a French surgeon during the Napelonic wars, originally described a wartime amputation through this part of the foot. Delaying treatment of Lisfranc injury can cause long-term or permanent damage.Lisfranc Fracture What is a Lisfranc fracture?Ī LisFranc fracture is a fracture or dislocation in the Lisfranc joints. If you suspect this or even a midtarsal joint sprain, then seek medical advice immediately. The injury may consist of a dislocation where there is only ligament damage or a fracture of one of the two bones may also occur. The lisfranc ligament connects the medial cuneiform bone (one of the tarsals) to the base of the 2nd metatarsal. It also occurs in road traffic accidents. The most common cause is stepping into a small hole, which causes a strong twisting force with a lot of body weight on top. If you suspect a midfoot sprain then you should always consider it a possibility. Lisfranc injury, or Lisfranc fracture-dislocation, is rare in sport but if left untreated it can have very severe consequences. Jaques Lisfranc was a surgeon in Napoleon’s army who described an operation for amputation through this joint. The term Lisfranc joint refers to the tarsometatarsal joints where the short tarsal bones in the midfoot meet the long bones or metatarsals in the foot.
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