What is a Lisfranc injury?
Lisfranc injuries, otherwise known as midfoot injuries, occur when the bones located in the midfoot are broken, or if the ligaments surrounding the midfoot are torn. These injuries can often be mistaken for a simple sprain, however, Lisfranc injuries should be taken seriously, as they may require surgery to fix and take several months to heal.
There are three different types of Lisfranc Injuries:
- Lisfranc sprain, where any of the three Lisfranc ligaments stretch or tear partially
- Lisfranc fracture, where any of the bones in the Lisfranc joint break
- Lisfranc dislocation, where a bone is move out of place in the joint
What causes a Lisfranc injury?
A Lisfranc injury can happen with a simple misstep or fall but can also be seen in high energy sport athletes, such as football and soccer. In sports, the most common cause of a Lisfranc injury is when weight is applied to the back (heel area) of another player’s foot while in a flexed position (i.e., pushing off the ground with a foot as if running). Severe Lisfranc injuries can occur because of trauma.
What are symptoms of a Lisfranc injury?
Symptoms of a Lisfranc injury include:
- Swelling and pain as it relates to the top of the foot
- Bruising on the bottom of the foot (can also appear on the top of the foot, too, however, a bruise appearing on the bottom of the foot is more suggestive of a Lisfranc injury
- Pain in the midfoot that worsens when walking, standing or pushing off with the affected foot
Often in Lisfranc injuries, pain may be so severe that weightbearing is not possible.
How is a Lisfranc injury diagnosed?
A Lisfranc injury is diagnosed starting with a physical examination and imaging tests ordered by your doctor. The crucial piece for the doctor to confirm is that the injury is within the midfoot, as these often are overlooked in injuries where the ankle is affected.
Physical examination will often include answering questions about your injury and the pain you’re experiencing, a visual inspection to check for swelling, bruising and tenderness, and a movement test to better evaluate range of motion and stability when standing, as well as walking.
Additional scans can help your doctor understand the severity of the injury. An x-ray may reveal a fracture or break of the bones in the Lisfranc joint, where as a CT scan may reveal more detail on the bones when needed. In other cases, an MRI scan can help reveal further damage to the soft tissues, like ligaments and cartilage.
What are treatment options for a Lisfranc injury?
Upon examination by a doctor, a patient with a suspected Lisfranc injury will likely undergo imaging to determine the extent of the injury. Your doctor may suggest an x-ray, CT scan, or even an MRI to get a better look at the affected foot.
There are several treatment options available for those dealing with a Lisfranc injury.
- Non-surgical treatment options are explored if there are no fractures, dislocated joints, or torn ligaments evident. These options likely will include wearing a non-weight bearing cast or boot for a couple months, gradually increasing from no weight bearing on the affected foot progressing up to bearing your full weight on the foot again.
- Surgical treatment options may be explored when there’s evidence of a bone fracture, joint dislocation, or torn ligaments. There are several different surgical procedures a doctor will consider based on the severity and nature of the injury; however, many will include securing the bones in place with plates, screws, or other hardware.
Recovery from a Lisfranc procedure may take an upwards of one year to be fully back to normal, but it’s important to follow your healthcare provider’s advice to ensure the best outcomes.