LISFRANC INJURIES

The Lisfranc Joint foot. A direct force often involves • Inability to bear weight he Lisfranc joint is the point at something heavy falling on the foot. (in severe injuries) T which the metatarsal bones Indirect force commonly involves • Bruising or blistering on the (long bones that lead up to the toes) twisting the foot. This can happen, arch—this is an important sign of and the tarsal bones (bones in the for example, when the foot catches a Lisfranc injury. Bruising may arch) connect. The Lisfranc ligament on a stirrup while falling from a also occur on the top of the foot. is a tough band of tissue that joins horse. • Abnormal widening of the foot. two of these bones. It is important for maintaining proper alignment Types of Lisfranc Injuries Diagnosis and strength of this joint. There are three types of Lisfranc Lisfranc injuries are sometimes injuries, which sometimes occur mistaken for ankle sprains, making together: the diagnostic process very • Sprains. The Lisfranc ligament, as important. To arrive at a diagnosis, well as other ligaments on the the foot and ankle surgeon will bottom of the midfoot, are ask how the injury occurred. The stronger than the ligaments on the surgeon will examine the foot and Metatarsals top of the midfoot. Therefore, determine the severity of the injury. when they are weakened through X-rays and other imaging a sprain (a stretching of the studies—such as a CT or MRI—may Lisfranc Joint ligament), patients experience be necessary to fully evaluate the instability of the joint in the extent of the injury.The surgeon middle of the foot. may also perform an additional

Tarsals • Fractures. A break in a bone in examination while the patient is the Lisfranc joint can be either under anesthesia to further evaluate an avulsion fracture (a small piece a fracture or weakening of the of bone is pulled off) or a break joint and surrounding bones. through the bone or bones of the midfoot. Treatment • Dislocations. The bones of the Anyone who has symptoms of a How do Lisfranc Lisfranc joint may be forced from Lisfranc injury should see a foot and Injuries Occur? their normal positions. ankle surgeon right away. If unable Injuries to the Lisfranc joint most to do so immediately,it is important commonly occur in automobile Signs and Symptoms to stay off the injured foot, keep it accident victims, military personnel, The signs and symptoms of a elevated (at or slightly above hip runners, horseback riders, football Lisfranc injury may include: level), and apply a bag of ice players, and participants of other • Swelling of the foot wrapped in a thin towel to the area contact sports. • Pain throughout the midfoot every 20 minutes of each waking Lisfranc injuries occur as a result when standing or when pressure hour.These steps will help keep the of direct or indirect forces to the is applied swelling and pain under control. Treatment by the foot and ankle • Physical therapy. After the swelling is compartment syndrome, in which surgeon may include one or more of and pain have subsided, physical pressure builds up within the tissues of the following, depending on the type therapy may be prescribed. the foot, requiring immediate surgery and severity of the Lisfranc injury: • Surgery. Certain types of to prevent tissue damage. A build-up • Immobilization. Sometimes the Lisfranc injuries require surgery. of pressure could damage the nerves, foot is placed in a cast to keep it The foot and ankle surgeon blood vessels, and muscles in the foot. immobile, and crutches are used will determine the type of Arthritis and problems with to avoid putting weight on the procedure that is best suited to foot alignment may develop. In injured foot. the individual patient. Some most cases, arthritis develops • Oral medications. Nonsteroidal injuries of this type may require several months or longer following anti-inflammatory medications emergency surgery. a Lisfranc injury,requiring (NSAIDs), such as ibuprofen, help additional treatment. L reduce the pain and inflammation. Complications of • Ice and elevation. Swelling is Lisfranc Injuries reduced by icing the affected area Complications can and often do arise and keeping the foot elevated, as following Lisfranc injuries. A possible described above. early complication following the injury

This information has been prepared by the Consumer Education Committee of the American College of Foot and Ankle Surgeons, a professional society of 6,200 foot and ankle surgeons. Members of the College are Doctors of Podiatric Medicine who have received additional training through surgical residency programs. The mission of the College is to promote superior care of foot and ankle surgical patients through education, research and the promotion of the highest professional standards. Copyright © 2007,American College of Foot and Ankle Surgeons • www.FootPhysicians.com