Sprains, fractures and dislocations are three types of Lisfranc injuries that sometimes occur together.
Sprains. The stronger ligaments including the Lisfranc ligament are on the bottom of the midfoot, whereas the weaker ligsments are on top of the midfoot. Thus, when the stronger ligaments are weakened by a sprain (a stretching of the ligament), patients experience joint instability in the middle of the foot.
Fractures. The Lisfranc joint may either involve an avulsion fracture, when a small piece of bone is pulled off; or a break through at least one bone of the midfoot.
Dislocations. The metatarsal or tarsal bones of the Lisfranc joint may become misaligned from their original positions.
The Lisfranc injury may include the following symptoms:
Swelling of the foot.
Pain in the midfoot when standing or applying pressure.
In severe injuries, the inability to stand on the foot.
Bruising or blistering on the arch or on the top of the foot.
Unusual widening of the foot.
Proper diagnosis is very important because Lisfranc injuries are sometimes mistaken for ankle sprains. Dr. Radovic will ask how the injury occurred, and evaluate the foot to determine the extent of injury.
X-rays and other imaging modalities may be ordered to determine a definite diagnosis. Dr. Radovic may further examine the foot for a fracture, or weakening of the joint and surrounding bones while the patient is under anesthesia.
Anyone who experiences aymptoms of a Lisfranc injury should see Dr. Radovic immediately. If you cannot be seen right away, make sure to rest the injured foot, elevate it at or above hip level, and apply an ice pack wrapped in a thin towel to the area every twenty minutes. These three steps will help control the pain and swelling. Depending on the type and severity of injury, Dr. Radovic will choose one or more of the following treatments:
Immoblization. The foot is sometimes casted to provide immoblization. Crutches are used to relive weight from the affected foot.
Oral medications. Nonsteroidal anti-inflammatory agents (NSAIDs), including Motrin and Aspirin help calm pain and inflammation.
Ice and elevation. Icing the injury and keeping the foot elevated reduces swelling.
Physical therapy. Dr. Radovic may prescribe physical therapy once the pain and inflammation subsides.
Particular cases of Lisfransc injuries require surgery. Dr. Radovic will determine the most suitable procedure for each individual patient. Some types if Lisfranc injuries might require emergency surgery.
Lisfranc injuries can and often are followed by complcations. One of the possible early complications is compartment syndrome, when there is pressure build-up within the tissues of the foot. Immediate surgery is required to prevent damage to the nerves, blood vessels and muscles of the foot.
Other complications highly likely to develoop are arthritis and alignment problems in the foot. Most often arthritis develops several months after a Lisfranc injury and requires additional treatment.