Caldwell and Meridian Podiatrist Explains Lisfranc Injuries and When Treatment is Necessary
A Lisfranc injury is any type of sprain, dislocation, or fracture of the Lisfranc joint in the middle of the foot. It doesn’t happen often in most people, but is frequently reported in athletes and physically active adults. Unfortunately, Lisfranc injuries are often misdiagnosed by physicians, raising patients’ long-term risk of complications like early-onset arthritis.
Rocky Mountain Foot & Ankle’s team of experienced podiatrists and certified foot and ankle surgeons can help. If you’re experiencing sudden or abrupt pain after sports practice, a competition, or an accident, schedule an appointment with our team for an accurate Lisfranc injury diagnosis and explore your options for a rapid recovery.
Understanding Lisfranc Injuries
The Lisfranc joint is situated midfoot near a cluster of small bones forming the arch. Five of these long bones, called the metatarsals, extend into the toe. They’re held together by a tight band of connective tissue, which positions each bone in place and assists in transferring weight from the lower leg downward.
Lisfranc joint injuries are rare and account for less than 0.2 percent of all foot fractures. Most are diagnosed in athletes, especially football and soccer players. The most common risk factors for Lisfranc damage include:
- Playing competitive or high-intensity sports
- Running
- Abrupt over-rotation of the foot
- Blunt force trauma
- Living with diabetes or nerve damage
Athletes and men in their 30s account for most Lisfranc injury diagnoses, but anyone whose foot is subjected to the right amount of pressure and force could develop similar problems.
Lisfranc joint injuries can sometimes be treated with bedrest and over-the-counter pain medication, but almost always warrant a professional podiatry exam. Left untreated, they might cause future long-term complications, including the early emergence of arthritis or a gradual collapse of the arches.
Types of Lisfranc Injuries ![Diagram of foot with Lisfranc injury | Experienced Idaho Podiatrist]()
Symptoms of these injuries include:
- Bruising around the foot, especially on its underside
- Swelling in and around the arch
- Pain, which may worsen significantly when walking, standing, or bearing weight
Here’s what many of our patients experience.
Sprain
This happens when the ligaments surrounding the joint are stretched or torn. A Lisfranc sprain is typically treated without invasive procedures but may require patients to forego sports and other physically intensive activities for several weeks.
Fracture
When any of the bones attached to the Lisfranc ligaments break, they’re categorized one of two ways:
- Avulsion fractures, in which a small piece of the bone breaks and disconnects from its foundation
- Complete fractures, when an entire bone—or several bones—break all the way through
Fractures are usually considered more severe than sprains; severe cases often require surgery. Recovery can last up to several months, but most people eventually return to full mobility in the activities they enjoy.
Dislocation
This is characterized by the separation of two or more bones that ordinarily meet at a joint. If left untreated, a Lisfranc dislocation fracture is often associated with a high risk of persistent secondary impairment. Patients with edema, tarsometatarsal joint discomfort, and the inability to bear weight are most at risk.
Moving Past a Serious Lisfranc Injury
Lisfranc injuries affect a region of the foot that is typically shielded from trauma. Since they are not especially common, many people attribute Lisfranc-related pain to more innocuous conditions. Even among non-podiatric medical providers, Lisfranc injuries are sometimes misattributed to a midfoot sprain—which is a different injury requiring alternate treatment.
Unfortunately, misdiagnosis has repercussions beyond inconvenience and delayed healing. In rare cases, Lisfranc joint instabilities can cause compartment syndrome, a sudden increase in muscle pressure that restricts blood flow and leads to permanent nerve injury and tissue damage.
If you have any type of midfoot pain, our podiatrists may undertake a comprehensive examination to rule out other conditions and ensure you receive the right care. This includes:
- Inquiring about your injury and its symptoms
- Performing a thorough physical examination to check for bruising, swelling, and range of motion
- Recommending medical imaging tests to identify the point of fracture or any other joint-related instabilities
Once a Lisfranc joint injury is diagnosed, we’ll customize a treatment plan based on the condition’s severity. For example, if the joint isn’t fractured and ligaments are intact, your foot might be placed in a boot to relieve pressure. However, in cases where the joint is fractured or dislocated, or ligaments are strained or torn, surgery may be the way to ensure effective healing.
Although Lisfranc recovery periods may typically last several months, early intervention is always best. Any delay or improper treatment has worse consequences, including the onset of arthritis and a permanent loss of mobility.
