A Lisfranc fracture, which gets its name from the doctor who first described the injury, is a break to the cluster of small bones in the mid-foot. These small bones, forming the arch of the top of the feet between the toes and the ankle, are held in place by connective tissues, such as ligaments.
Causes of Lisfranc foot fracture
While most of these small bones are held in place by ligaments, the space between the first and second metatarsal bones in the mid-foot area is not supported by ligaments, making this an area prone to injury. The most common causes of Lisfranc foot fracture are twisting the foot or dropping a heavy object on the foot. In some cases, high impact accidents can also result in a Lisfranc foot fracture.
Symptoms of Lisfranc Foot Fracturescan include:
- Swelling and pain at the top of the foot
- Inability to put weight on the foot (in more severe cases)
In many cases, Lisfranc foot fractures can be mistaken for sprains. However, it is important that these fractures are properly diagnosed because untreated Lisfranc fractures can result in serious complications including joint degeneration, compartment syndrome, and more.
If these symptoms do not improve in a day or two, it is wise to ask your doctor for a referral to an orthopedic specialist who can determine the nature and severity of the injury and the best course of treatment.
Diagnosing Lisfranc Foot Fracture
A doctor will perform a physical examination, manipulating the foot to assess the level of pain and the site of injury. A circular motion with the foot (heel held steady) will produce significant pain with a Lisfranc injury but minimal pain with a sprain. A doctor will also order diagnostic tests—x-ray, CT scan, or MRI, to determine the precise nature of the injury, the type of fracture and its severity.
Treatment of Lisfranc Midfoot Fractures
In cases of uncomplicated Lisfranc fracture where the bones have not been displaced, a cast may be sufficient to immobilize the foot long enough for it to heal. Casts for midfoot fracture are worn on average from 6 to 8 weeks. Once the cast is removed, a rigid arch supporting brace may be worn and rehabilitating exercises may be recommended to help rebuild strength, stability and range of motion.
In more serious cases of Lisfranc fracture, surgery may be necessary to realign the bones and stabilize the area using wires, screws, pins or plates. Following surgery, a cast may be used and activities restricted.
In cases where the bones develop arthritis or other complications bone fusion may be necessary. To avoid complications, it is important to follow doctor recommendations about limiting activities and keeping weight off the injured foot.