The Lisfranc joint is the junction of the metatarsal bones (long bones that lead up to the toes) and the tarsal bones (bones in the arch). A fibrous tissue called the Lisfranc ligament joins two of these bones. This junction plays an important role in joint strength and proper alignment.
Lisfranc injuries are caused by either a direct or indirect force to the foot. A direct force usually involves a heavy object falling on the foot. An indirect force often involves twisting the foot.
These injuries are most commonly seen in runners, horseback riders, football players and athletes of other contact sports. Military personnel and victims of motor vehicle accidents may also be affected. Lastly, simply missing a step on a staircase can cause a Liisfranc injury.
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 mid-foot, whereas the weaker ligsments are on top of the mid-foot. 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 mid-foot.
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:
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 symptoms 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 immobilization. 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 complications. 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 develop are arthritis and alignment problems in the foot. Most often arthritis develops several months after a Lisfranc injury and requires additional treatment.