Lisfranc Injury of the Foot
By Justin Delicato, PTA, Site Coordinator
What is a Lisfranc Injury?
The quick answer, a Lisfranc injury occurs when the midfoot bones are broken or ligaments of the midfoot are torn. The Lisfranc joint is the area of the foot where the metatarsals and tarsal bones connect. The Lisfranc ligament supports the Lisfranc joint. These injuries can vary in complexity and are oftentimes mistaken for simple sprains. However, the midfoot (arch of the foot) plays a crucial role in functional stability and walking. In other words, it is important to be properly evaluated by a foot and ankle orthopaedic physician.
Lisfranc Injury
What causes a Lisfranc Injury?
This injury occurs from a fall when the ankle suddenly twists. This can happen with a simple twist and fall on top of a foot that is pointing downward. A direct blow to the mid-foot (during sports, car accidents, fall from a height, etc.) can injure this foot area.
Types of Lisfranc Injuries
There are three main types of Lisfranc injuries: sprains, fractures, and dislocations.
- Sprains: Create instability of the midfoot, as the weakened ligament cannot adequately support the foot’s arch after an injury.
- Fractures: Breaks can occur in the associated midfoot bones – tarsals and metatarsals.
- Dislocations: The supporting midfoot bones may shift out of place.
Image of where Lisfranc Injuries occur
Symptoms of Lisfranc Injuries
- Tenderness at the site of injury/top of the foot.
- Swelling.
- Bruising in the midfoot
- Inability to put weight on your foot
Diagnosing Lisfranc Injuries
In order the make the proper diagnosis for the injury, your physician may:
- Take a thorough history.
- Perform a physical exam.
- Take x-rays (to determine fractures and position of the bones), sometimes standing.
- MRI or CT Scan
Treatment of Lisfranc Injuries
There are two main approaches to treat a Lisfranc Injury: Conservative (non-surgical) or Surgical.
- Non-surgical treatment. These do not involve significant tears, fractures, or dislocations. A walker boot or cast (non-weight-bearing only) allows the injury to heal.
- Rest by using crutches and staying off of your feet.
- Ice for 20 minutes several times a day.
- Immobilization with a walking boot.
- Elevation of the foot above height of your heart to decrease swelling.
- Surgical treatment. Realign the bones to encourage appropriate healing and functional ability. Sometimes, an ORIF (open reduction internal fixation) must be performed. This operation uses hardware (plates, screws, etc.) to ensure the integrity of the repair.
Rehabilitation/Recovery
Individuals with Lisfranc injuries may benefit from physical therapy services, as advised by their MD. Therefore after proper healing, rehab efforts encourage foot mobility and strengthening for everyday function. The recovery is very difficult for a possible return to sport. In conclusion, if you think you have this injury, JOI can help you get back on the road to recovery. To schedule with JOI Rehab, please call 904-858-7045.
Related Article by Dr. Vosseller: What is a Lisfranc Injury?
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Author: Justin Delicato, PTA, Site Coordinator
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