At Southern Maryland Foot & Ankle, we treat various foot injuries, one of the more severe being Lisfranc injuries. While this condition may not be as well-known as other foot injuries, it can significantly impact your mobility and require prompt attention. In this blog post, we’ll explain what Lisfranc injuries are, how they occur, their symptoms, and treatment options to help you recover.
What Is a Lisfranc Injury?
A Lisfranc injury affects the midfoot, which includes the Lisfranc joint complex. This area is made up of a group of bones and ligaments that connect the forefoot (the area near your toes) to the hindfoot (closer to the ankle). The Lisfranc joint plays a crucial role in stabilizing the arch of the foot and supporting your body’s weight when you walk, run, or stand.
Lisfranc injuries occur when there is damage to this joint complex, typically involving fractures, dislocations, or tears of the ligaments. These injuries can range from mild to severe, and they often lead to long-term complications if not treated correctly.
Causes of Lisfranc Injuries
Lisfranc injuries can occur due to both high-impact trauma and low-impact missteps. Some common causes include:
- Trauma: High-impact injuries, such as car accidents or falls from significant heights, can lead to severe damage to the Lisfranc joint.
- Sports Injuries: Athletes, especially those in contact sports like football or soccer, are at risk of a Lisfranc injury from sudden twists, heavy tackles, or direct impact to the foot.
- Missteps: A common cause of Lisfranc injuries is twisting the foot unexpectedly. For example, missing a step on stairs or stumbling can cause the foot to twist in a way that tears the ligaments in the midfoot or fractures the bones in the area.
- Falling with a Rotated Foot: Falling while the foot is in a rotated position or while bearing weight can cause the Lisfranc joint to become unstable, leading to injury.
Symptoms of Lisfranc Injuries
A Lisfranc injury can be challenging to diagnose because its symptoms may resemble other foot problems, such as sprains or fractures. If you suspect a Lisfranc injury, it’s important to recognize the following symptoms:
- Pain and Swelling: Pain in the midfoot area that increases with standing or walking is a key sign of a Lisfranc injury. The pain can be sharp or achy, and swelling may occur on the top or bottom of the foot.
- Bruising: Bruising on the bottom of the foot (plantar side) is often a tell-tale sign of a Lisfranc injury, though bruising may also occur on the top of the foot.
- Difficulty Bearing Weight: If it’s hard or impossible to bear weight on your foot due to pain, this could be a sign of a Lisfranc injury.
- Midfoot Instability: The Lisfranc joint complex is crucial for stability, so if the injury is severe, you may feel like your foot is unstable or that something is “off” when you try to stand or walk.
Diagnosing Lisfranc Injuries
If you experience any of the above symptoms, it’s essential to seek a professional evaluation. At Southern Maryland Foot & Ankle, we diagnose Lisfranc injuries using a combination of physical exams and imaging tests. Here’s what you can expect during your visit:
- Physical Examination: We’ll ask about the injury and your symptoms while examining your foot for signs of swelling, bruising, and instability.
- Imaging Tests: X-rays are usually the first step to check for fractures or dislocations. However, if the injury involves ligament damage (without broken bones), additional tests like MRI or CT scans may be necessary to get a clearer picture of the soft tissues and bones.
Treatment Options for Lisfranc Injuries
The severity of a Lisfranc injury will determine the appropriate treatment plan. Treatment options range from conservative methods to surgical intervention.
1. Conservative Treatment
Mild Lisfranc injuries that do not involve fractures or major dislocations can often be treated conservatively. This approach includes:
- Immobilization: You may be required to wear a cast, walking boot, or brace for several weeks to allow the injured ligaments or bones to heal. During this time, you must avoid bearing weight on the injured foot.
- Rest and Elevation: Resting the injured foot and elevating it can reduce swelling and help speed up the healing process.
- Ice Therapy: Applying ice to the injured area several times a day can help reduce pain and inflammation.
- Physical Therapy: After the immobilization phase, physical therapy may be recommended to restore strength, flexibility, and function to the foot.
2. Surgical Treatment
In cases where the injury involves fractures, dislocations, or severe ligament damage, surgery may be necessary to realign and stabilize the bones and ligaments in the Lisfranc joint. Surgical options include:
- Internal Fixation: Screws, plates, or other hardware may be used to hold the bones in place while they heal. This is typically done for severe fractures or dislocations.
- Fusion Surgery: In some cases, fusing the bones in the midfoot may be necessary to stabilize the joint and prevent long-term instability.
After surgery, you’ll need to avoid weight-bearing activities for several weeks or months and follow a rehabilitation plan to regain strength and mobility in the foot.
Recovery and Long-Term Outlook
Recovery from a Lisfranc injury can take several months, depending on the severity and the type of treatment required. Early and accurate diagnosis, along with appropriate treatment, is crucial to ensure proper healing and reduce the risk of complications. Possible long-term complications of untreated or improperly treated Lisfranc injuries include:
- Chronic Pain: If the injury does not heal correctly, chronic pain in the midfoot may develop.
- Arthritis: The Lisfranc joint is prone to developing arthritis, especially after a severe injury or if the joint is not properly stabilized.
- Foot Instability: Without proper treatment, the arch of the foot may collapse, leading to instability and difficulty with normal activities like walking or running.
Following treatment, it’s important to adhere to your rehabilitation plan and return to activity gradually to ensure a full recovery.
Preventing Lisfranc Injuries
While not all Lisfranc injuries are preventable, there are steps you can take to reduce your risk, especially if you are involved in sports or high-impact activities:
- Wear Proper Footwear: Ensure that your shoes provide good arch support and fit properly, particularly when engaging in sports or activities that involve running or jumping.
- Strengthen Foot Muscles: Strengthening the muscles of the foot and ankle can help stabilize the Lisfranc joint and reduce the risk of injury.
- Be Cautious with High-Impact Sports: If you participate in high-impact sports, practice proper techniques and be mindful of uneven or unstable surfaces that could increase your risk of injury.
Conclusion
Lisfranc injuries can be painful and debilitating, but with early diagnosis and the right treatment, most patients can recover and return to their normal activities. At Southern Maryland Foot & Ankle, we specialize in diagnosing and treating foot and ankle injuries, including Lisfranc injuries. If you’ve experienced a foot injury or are experiencing any of the symptoms mentioned, don’t hesitate to reach out for a consultation.