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Lisfranc Injuries
What is A Lisfranc InjurY
The Lisfranc joint is where the metatarsal bones (long bones that lead up to the toes) and the tarsal bones (bones in the arch) connect. The Lisfranc ligament joints these bones together to maintain proper alignment and strength to the joint and arch.
How Do Lisfranc Injuries Occur?
Most common causes of injuries include a twisting of the foot while the ball of the foot is planted. This can happen in a simple fall, missing a step on a staircase or sports related activities like running or being tackled in football. More severe injuries of the Lisfranc joint can offer with crush injuries where something heavy falls on the foot, the foot gets rolled over by something heavy or the foot is caught in between something. Motor vehicle accidents can also cause injuries to the Lisfranc joint.
Types of Lisfranc Injuries
- Sprain- This is least severe injury that can occur. During a sprain, the ligaments of the Lisfranc joint are stretched or partially torn.
- Dislocation- When the joint is dislocated, the joint is no longer aligned. This occurs when the ligament within the Lisfranc joint are fully torn.
- Fractures- Fractures can either be an avulsion or a fleck of bone that breaks off the bone where the ligaments attach or the bones break through the cartilage of the Lisfranc joint.
Symptoms
- Swelling
- Pain through the arch when standing or pressure is applied
- Inability to bear weight in more severe injuries
- Bruising or blistering of the middle of the foot
- Abnormal widening of the foot
Diagnosis
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.
Treatment
Non-surgical
- Rest, ice, compression, elevation
- Immobilization
- Oral medication- NSAIDs
- Physical therapy
Surgical
If nonsurgical treatment fails to adequately relieve pain and improve stability, surgery may be needed. However, in certain types of Lisfranc injuries, surgery is required. In more severe cases, surgery is performed to reduce the fractures or dislocations that can cause damage to the surrounding tissues, nerve and blood vessels. In cases that are not surgically fixed or only the fractures fixed leaving the joints mobile, arthritis can develop which may result in additional treatment and surgeries.