Lisfranc (Midfoot) Fracture: Causes, Symptoms And Treatment

Lisfranc (midfoot) injuries occur when the bones in the midfoot are fractured or the supporting ligaments get stretched beyond their capability. A Lisfranc (midfoot) fracture can range from mild to severe depending on the number of bones and joints affected. Any midfoot injury can cause problems in walking as the midfoot helps in providing stability to the arch and maintain the walking gait.

The midfoot joint complex comprises of small bones that create an arch on the top of the foot. This joint complex is also known as the Lisfranc joint after the French surgeon Jacques Lisfranc de St. Martin.

Causes

• Twisting of the foot followed by falling
• Football and soccer players fall under the high-risk category
• Direct trauma such as falling from a height

Symptoms

• Tenderness and swelling in the injured area
• Bruising can be seen on the top and bottom of the foot
• Pain that intensifies with standing or walking
• Difficulty in walking properly

Diagnosis

• The doctor may take note of the history of the injury along with the visible symptoms
• A thorough physical examination of the foot and ankle may be conducted
• The doctor may look for symptoms such as bruising and tenderness
• A stress examination on the midfoot is also conducted to check for the severity of pain
• The doctor may also perform a “piano key” test wherein the toes are moved up and down to see if the patient experiences any discomfort
• The patient may be asked to stand on one foot on “tiptoes” to check the extent of damage occurred
• Imaging tests such as X-Ray, Magnetic Resonance Imaging (MRI) or Computerized Tomography scan (CT) scan may also be done to take a closer look at the bone and tissue structures in the midfoot

Treatment

• The treatment plan for a Lisfranc (midfoot) fracture depends on the severity of the injury.

Non-surgical treatment

• Non-surgical treatment is beneficial in case there is no fracture, dislocation or tearing of the ligaments
• The patient may be asked to wear a light cast for six weeks till the injury heals completely
• The patient may be advised not to put any weight on the affected foot
• A removable cast boot or an orthotic may be suggested as the next step of treatment

Surgical treatment

• Surgical intervention may be required in case there is a fracture in the midfoot
• In a process known as internal fixation, the bones are re-positioned using plates and screws
• In cases of a severe injury, the process of fusion is performed wherein the damaged bones are fused together into a single piece