Lisfranc injuries occur at the midfoot, where a cluster of small bones forms an arch on top of the foot between the ankle and the toes. From this cluster, five long bones (metatarsals) extend to the toes. The second metatarsal also extends down into the row of small bones and acts as a stabilizing force.
The bones are held in place by connective tissues (ligaments) that stretch both across and down the foot. However, there is no connective tissue holding the first metatarsal to the second metatarsal. A twisting fall can break or shift these bones out of place.
Treatment for a Lisfranc injury depends on its severity. If the bones have not been forced out of position, you will probably have to wear a cast and refrain from putting weight on the foot for about six weeks. When the cast is removed, you may have to wear a rigid arch support. Your orthopedist will also recommend foot exercises to build strength and help restore full range of motion.
Often, operative treatment is needed to stabilize the bones and hold them in place until healing is complete. Pins, wires, or screws may be used. Afterwards, you will have to wear a cast and limit weightbearing on the foot for six to eight weeks. A walking brace may be prescribed as you progress to a shoe.
You may also have to wear an arch support and a rigid-soled shoe until all symptoms have disappeared. In some cases, if arthritis develops in these joints, the bones may have to be fused together.
It is important to follow your doctor's orders and refrain from activities until you are given the go-ahead. If you return to activities too quickly, you may easily suffer another injury that results in damage to blood vessels, development of painful arthritis, and an even longer healing time.
*Source: American Orthopaedic Foot & Ankle Society® http://www.aofas.org