Lisfranc Surgery

Lisfranc surgery is a specialized procedure aimed at addressing injuries and deformities affecting the Lisfranc joint, a critical junction between the midfoot and forefoot. Named after French surgeon Jacques Lisfranc de St. Martin, who first described injuries to this ligament, this surgery aims to restore stability and alignment to the foot while alleviating pain and dysfunction.

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Definition

The Lisfranc ligament connects two important bones in the midfoot: the medial cuneiform and the second metatarsal. Injury to this ligament, along with other ligaments surrounding the Lisfranc joint, can lead to instability and disruption of foot joints. Lisfranc surgery looks to realign the bones and restore normal foot function by reconstructing or stabilizing the damaged joint.

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General Considerations

Candidates for Lisfranc surgery typically present with midfoot joint instability, anatomical misalignment, and persistent pain. Diagnosis often involves imaging studies such as weight bearing X-rays, CT scans, or MRI scans to assess the extent of the injury and plan appropriate treatment. Surgical intervention is considered when conservative measures fail to provide relief or when there is significant joint displacement.

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Surgical Technique

Lisfranc surgery is usually performed as an outpatient procedure under general or regional anesthesia. The surgeon makes incisions to access the Lisfranc joint and surrounding structures. Depending on the severity of the injury, various techniques may be employed, including ligament repair, bone realignment, or joint fusion. Internal fixation devices such as screws, plates, or wires are used to stabilize the bones and facilitate healing.

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Recovery

Following Lisfranc surgery, patients undergo a period of immobilization to allow for bone healing and tissue repair. Weight-bearing status and activity restrictions are determined by the surgeon based on the specific surgical approach and individual patient factors. Pain management, elevation, and physical therapy may be prescribed to facilitate recovery and optimize outcomes. Patients are advised to follow post-operative instructions diligently and attend follow-up appointments for monitoring and evaluation.

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Risks and Complications

As with any surgical procedure, Lisfranc surgery carries potential risks and complications. These may include infection, nerve or blood vessel injury, delayed healing, and adverse reactions to anesthesia. Post-operative arthritis and hardware-related issues such as irritation or loosening may also occur. Patients should discuss potential risks with their surgeon and adhere to post-operative guidelines to minimize complications.