Your Lisfranc joint is located in the midfoot area, and it’s a hub where the five metatarsal bones connect with the smaller cuboid bone in the medial, middle and lateral cuneiform bones. These bones are stabilized and held in place by a collection of ligaments, and together they work in harmony to ensure the transfer of stress across the foot goes as expected when a person is walking or running. The area is rather well protected, but severe trauma to the midfoot can lead to Lisfranc sprains or fractures. In today’s blog, we explore how Lisfranc injuries develop and the common course of treatment for these injuries.

Causes, Symptoms And Types Of Lisfranc Injuries

The Lisfranc injury dates back to the early 1800s during the Napoleonic Wars. It was during that time that the injury was first documented by the French surgeon Jacques Lisfranc, who noticed the injury in a soldier who had fallen off his horse while his foot unfortunately remained caught in the stirrup. The soldier suffered acute trauma to the foot while a rotational force was applied as the foot was stuck in a plantar flexed position. While these injuries can occur in high-energy collisions or with much less trauma, they tend to develop as a result of a rotational force while the foot is plantar flexed, which overloads the midfoot area.

This type of trauma can lead to a few different problems with the Lisfranc joint. Depending on the severity of the injury, you may experience any of the following:

• Lisfranc Strain – When the ligaments that support the joint are overstretched or partially torn.
• Lisfranc Fracture – When any bones in the midfoot joint break.
• Lisfranc Dislocation – When trauma forces a bone in the area out of its natural position.

Symptoms of a Lisfranc injury will vary based on your specific injury, but many patients report different degrees of pain, tenderness, swelling, difficulty bearing weight and increased discomfort when walking or running. If you’re experiencing any of these symptoms, especially if you have reason to believe you injured your midfoot, make it a point to connect with a foot and ankle specialist like Dr. McDonald.

Diagnosing And Treating Lisfranc Injuries

During the diagnostic phase, your surgeon will talk with you about your symptoms and how the injury occurred. If you were injured during a sport like soccer or football, they’ll likely ask specific questions about how you were positioned during the moment of injury to see if that rotational force was likely present when the foot was under stress. They’ll also conduct a physical exam to look for signs of swelling and tenderness, and they may have you stand or perform a few other simple movements to see how your body responds.

Your doctor may have a pretty good idea that a midfoot issue exists, but imaging tests can tell a more in-depth story. X-rays can help to diagnose a Lisfranc fracture or dislocation, while an MRI or CT scan can assess the health of the supportive soft tissues that stabilize the complex.

Treatment will be based on your specific injury and your individual needs and recovery goals. For mild to moderate sprains, you may be able to make a full recovery with the help of rest, physical therapy and a gradual return to weight-bearing activities. Oftentimes the patient is placed in a walking boot for 4-8 weeks to help further protect the area as it works to heal. Once the boot is removed, you’ll work with a physical therapist to improve strength and range of motion in the foot as you work to return to high impact activities.

For fractures, dislocations or complete ligament tears, surgery is typically the recommended course of care. It’s imperative that this area heals correctly so that it can continue to stabilize the foot, but these types of injuries don’t have the best healing rates on their own. Surgery to reposition the broken or dislocated bones or to address a torn ligament can provide the right environment for correct healing to run its course. Following your surgery, you’ll partake in a similar recovery plan as someone who pursued the above non-operative treatment plan, with an extended period in a walking boot before jumping into a PT routine. A return to full activities or competitive sports can take anywhere from 6-12 months following your operation.

For more information about Lisfranc injuries, or for assistance managing a different foot or ankle issue, reach out to Dr. McDonald and his team today at (860) 244-8889.