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Midfoot Fracture Dislocations (Lisfranc Injuries)

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As with most injuries to the foot and ankle, it is very important to visit with an orthopaedic surgeon as soon as possible after the injury to discuss its best management.

Midfoot fracture dislocations, also known as Lisfranc injuries, are traumatic injuries to the tarsometatarsal joints of the foot. This commonly occurs in sporting events and high energy trauma such as motor vehicle collisions. These joints are important for maintaining the height of the arch. These injuries can be relatively mild such as a sprain, or very severe with complete dislocation of the joints. Treatment options depend on the severity of the injury. It is important to visit with an orthopaedic surgeon as soon as possible after this injury to discuss its management. A CT scan is often needed to evaluate these particular injuries in order to look for subtle instability of the joints. If left untreated, these injuries often lead to painful arthritis of the involved joints and collapse of the midfoot.

Treatment

Mild sprains can sometimes be treated in a cast with restriction of weight bearing on that leg. Injuries that involve any instability of the joints should be treated surgically. Surgical options will be recommended by your orthopaedic surgeon but generally involve stabilization of the joints with screws and/or plates with or without fusion of the joints. The decision to permanently fuse the joints is determined by many factors including severity of injury and age and activity level of the patient. Post-operatively, a cast and non-weightbearing on that leg are needed for a minimum of 6 weeks. Austin Ankle Associates has vast experience in treating these injuries and expertise in foot and ankle trauma.