Lisfranc Injury

Lisfranc Joint Complex

The Lisfranc joint complex includes the bones and ligaments that connect the midfoot and forefoot. It is named after French surgeon Jacques Lisfranc de St. Martin, who served in the Napoleonic army in the 1800s. The midfoot is critical in stabilizing the arch and in walking (gait). Lisfranc injuries include ligament strains and tears, as well as fractures and dislocations of bone. The severity of the injury can vary from simple to complex, involving many joints and bones in the midfoot.

 

Mechanism of Injury

A Lisfranc injury is often mistaken for a simple sprain, especially if the injury is a result of a straightforward twist and fall. However, injury to the Lisfranc joint is not a simple sprain that should be simply "walked off." It is a severe injury that may take many months to heal and may require surgery to treat.

These injuries can happen with a simple twist and fall. This is a low-energy injury. It is commonly seen in football and soccer players. It is often seen when someone stumbles over the top of a foot flexed downwards.

More severe injuries occur from direct trauma, such as a fall from a height. These high-energy injuries can result in multiple fractures and dislocations of the joints.

 

Signs & Symptoms

  • Top of the foot may be swollen and painful
  • Bruising along the bottom of the foot is highly suggestive of a Lisfranc iNjury
  • Inability to bear weight in severe injuries
  • Abnormal widening of the foot
  • Pain that worsens with standing, walking or attempting to push off on teh affected foot

 

Physiotherapy Management

You will be referred for immediate imaging (MRI or CT) to ascertain the presence of any fractures or joint dislocations.  More severe injuries involving fractures or joint dislocations are managed surgically and your physiotherapist will be there to guide your rehabilitation following.

Minor injuries in which only minimal ligament damage is sustained in the midfoot can be managed conservatively over a 6-week period of immobilisation in a walking boot. You may be able to walk in this boot as tolerated depending on pain levels.

 

 

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