A Lisfranc injury affects the joints and ligaments of the midfoot, situated between the bones known as the medial cuneiform and the second metatarsal. This injury is named after the French surgeon Jacques Lisfranc de St. Martin, who first described it in the 19th century.

Causes of Lisfranc injuries vary and can include car accidents, sports injuries, or simple slips and falls. In some cases, the injury may be mistaken for a foot sprain, particularly if X-rays do not reveal any broken bones. However, timely and accurate diagnosis by a foot and ankle orthopedic surgeon is crucial to prevent potential complications.

‍

Symptoms

Symptoms typically involve swelling and pain on the top of the foot near the instep, often accompanied by bruising. Severe cases may result in foot distortion and significant pain while bearing weight, whereas milder injuries may allow for walking with minimal discomfort.

‍

Causes

Low-energy injuries can occur from twisting the back of the foot or pressing down with the ball of the foot planted on the ground during activities like football or everyday missteps. High-energy injuries, on the other hand, result from direct trauma such as car accidents or falls from heights.

‍

Diagnosis

The diagnosis of a Lisfranc injury involves assessing the circumstances of the injury, symptoms, and a comprehensive foot and ankle examination. X-rays are typically used to identify broken or shifted bones, sometimes requiring imaging while standing to better visualize bone displacement. Additional tests like MRI or CT scans may be needed to evaluate ligament and bone damage.

‍

Treatments

Treatment options vary depending on the severity of the injury. Non-surgical approaches may involve immobilization in a cast or boot for at least six weeks to allow ligament and bone healing. Surgical intervention may be necessary if bones or ligaments are significantly displaced, with procedures aiming to restore foot anatomy through the placement of plates and screws.

‍

Recovery

Recovery from Lisfranc surgery can be lengthy, involving non-weight bearing casting followed by a period in a walking boot. Physical therapy may be necessary to regain foot and ankle strength and mobility. Returning to full activity, including sports, may take up to a year.

‍

Risks and Complications

Complications of Lisfranc injuries can include midfoot arthritis, chronic pain, nerve and tendon damage, and surgical complications such as infection. Some patients may require additional treatments like joint fusion to manage pain and restore function.