Dr Jeff Ling & Dr David Lunz
Sydney Orthopaedic Specialists: Foot & Ankle Institute
A Lisfranc injury is named after Jacques Lisfranc de St Martin, a French military surgeon in Napoleon’s army who first described the injury in horsemen who fell off their horses with their foot stuck in the stirrups. This twisting, high-impact injury through the middle of the foot is seen in modern settings during contact sports such as rugby league or union but generally can be the result of any twisting force through the midfoot as seen in a traffic collision, industrial accident, or even simply falling over awkwardly.
Signs & SymptomsPain and swelling around the midfoot are typical. Bruising around the undersurface of the arch of the foot may also be seen. You may not be able to bear any weight and/or the foot may be painful to walk on.
InvestigationsPlain Xrays are generally the first investigation, but if the injury is subtle and a Lis Franc injury is suspected, then a CT or MRI may be ordered.
TreatmentInitially, rest, ice, and elevation to allow for the swelling to subside. This typically takes 7 – 10 days. In very mild injuries, a period of non-weightbearing in a boot can be prescribed.
In the vast majority of cases, surgery is necessary. This involves an incision over the top of the foot, through which the bones and soft tissues are realigned. Following this, specially designed metal implants are inserted which hold everything in place, guiding the healing process whilst the midfoot heals. Failure to rigidly and anatomically fix these injuries leads to chronic midfoot pain, arthritis, and flattening of the arch of the foot.
Post-OpYou will be in plaster for the first two weeks. You will then be put into a boot and can start range of motion exercises but cannot weight bear till the 6 week mark.
At 6 weeks, you start weight bearing in the boot, along with formal physiotherapy. You may start transitioning out of the boot into athletic shoes with an arch support after 12 weeks. You may undertake low impact exercises such as walking, swimming and elliptical till the 6 month mark when the plates and screws are removed. Thereafter, high impact activities like running may be resumed.
This is one of the more significant injuries of the foot and total recovery time is 12 months.
Xray of Lisfranc Injury
X-ray of Lisfranc Injury
Lisfranc Repair Surgery
Lisfranc Repair Surgery
Any surgical or invasive procedure carries risks. The information provided here is for general educational purposes only. Patients should discuss their particular situation with the doctors of Sydney Orthopaedic Specialists: Foot & Ankle Institute.