A Lisfranc injury occurs when bones break or ligaments tear in the middle region of the feet. This particular type of injury is commonly seen in football players, motorcyclists, and horseback riders. Often mistaken for an ankle sprain, a Lisfranc injury is more serious in nature and may take many months to heal.
What is a Lisfranc Injury
The midfoot plays an essential role in stabilizing your arch and in force transmission during walking. It contains a cluster of small bones that form the arch of the foot; and from this cluster, five long bones, called the metatarsals, extend to the toes. These bones are held in place by the Lisfranc joint complex.
A Lisfranc joint injury occurs when one or more of these bones break or shift out of place. Depending on the direction of the displaced metatarsals and their degree of displacement, Lisfranc injuries are further classified into three categories:
- Sprains or rupture of ligament, which results in a marked instability of the midfoot.
- Fractures, which is either an avulsion fracture (small piece of bone is pulled off) or a break through the bone or bones of the midfoot.
- Dislocation, when the bones are forced out of their normal position.
Causes of Lisfranc Injury
A Lisfranc joint injury occurs as a result of direct or indirect forces on the foot. Direct Lisfranc injuries are usually caused by a crush injury, such as a heavy object falling on the foot or falling from a significant height; while indirect Lisfranc injuries are usually caused by twisting the foot.
Lisfranc injuries rarely affect the general population. They commonly occur in sports and activities such as football, running, gymnastics, windsurfing, or snowboarding.
Symptoms of Lisfranc Injury
Symptoms of a Lisfranc joint injury will vary according to the severity of the injury. Common symptoms include:
- Pain in your midfoot (worse when standing or walking)
- Inability to put weight on your foot
- Swelling or deformity in the midfoot
- Bruising on both the top and bottom of the foot
- Numbness and tingling of midfoot and toes
Diagnosis of Lisfranc Injury
Since a Lisfranc injury typically occurs from a simple twist and fall, and is easily mistaken for a minor sprain, an accurate diagnosis is crucial to avoid a delay in treatment.
Your doctor will begin with a health history and do a physical assessment of your foot. They may also perform the piano key test by moving each of your toes one by one to see if this causes pain.
To get a more detailed picture and to determine the extent of the injury, a series of imaging tests may also be done, including X-rays, MRI, and CT scans.
Treatments for Lisfranc Injury
Lisfranc injury recovery time also depends on the severity of the injury. A mild Lisfranc injury can be treated the same way as a simple sprain — bed rest, application of ice, and elevation of the injured foot. Crutches can also help alleviate pain, and in more serious cases, casts can be worn for up to six weeks.
Surgery is recommended for injuries with broken bones or abnormal positioning of joints. This includes:
- Internal fixation wherein plates or screws are used to reposition the foot bones and hold them in place while healing.
- Fusion treatment wherein the cartilage around your joints is removed prior to adding screws.
If you undergo surgery, a cast is required to be worn for six to eight weeks after the procedure, and you will most likely need a crutch to help support the body weight. Pins and plates are then taken out after four to six months.
Many people suffer from ankle and foot injuries. They can be dangerous and are caused by a variety of circumstances. Contact our podiatrist at DeNiel Foot & Ankle Center if you are experiencing discomfort, feel you have been injured, or have a foot abnormality. Our foot and ankle specialist Houston will assess your condition and give you the best possible foot and ankle care.
