A Lisfranc injury involves the joints and/or the ligaments of the middle of the foot. The injury can result from a major accident or a simple slip and fall. Sometimes this injury can be mistaken for a “sprain,” and not obtaining treatment can sometimes lead to more significant problems. The degree of injury can range from mild to severe.
If the ligaments and the bones in the middle of the foot are not injured severely, and bones are not shifted out of their normal positions, nonsurgical treatment can be successful with casting and staying of the foot. This is generally needed for 6 weeks. Your doctor will follow up regularly with X-rays to assure the bones maintain their good position during the recovery. If the bones or ligaments are injured, causing them to shift out of their normal positions, surgery is likely necessary to restore the anatomy. Often, these plates and screws are removed later once the bones and ligaments have healed.
The expected recovery depends on the initial severity of the injury. For most cases of surgery, patients will be in a cast and not be able to put weight on the foot for 6 weeks, followed by 6 weeks in a walking boot. Physical therapy may be needed to strengthen the foot and ankle and help regain ability to walk. Return to full function, running, and sports can take about one year.
The outcome for Lisfranc injuries depends on the severity of the injury. Some patients will not be able to return to their pre-injury level of function or athletics even with well-performed treatment. The cartilage joint surfaces are commonly injured in these injuries and may lead to foot arthritis of the middle of the foot. It is common that after this injury, pain will persist in these joints and on some occasions, additional surgery, such as fusion (gluing together of the joints), may be necessary to relieve pain.
Lisfranc injuries may result in arthritis and chronic pain in the middle of the foot. This may require additional surgery. With surgery, injury to the nerves and tendons may occur. Because of the swelling that often occurs with this injury, wound opening, infection, and/or further swelling of the foot may occur after surgery.
*Source: American Orthopaedic Foot & Ankle Society® http://www.aofas.org