Orthopedic Treatment For Lisfranc (Midfoot) Injury

Lisfranc injuries refer to injuries affecting the midfoot bones or ligaments. These injuries are often mistaken for sprains, but are actually a lot more severe, and might take months to heal. In some cases, surgery might be required for the treatment of a Lisfranc injury. The common symptoms of such an injury are swelling on top of the foot, severe foot and ankle pain, and bruising on or below the foot. Bruising below the foot is usually a sure-shot sign of a Lisfranc injury. If you experience any of the above symptoms, you should immediately visit an orthopedic doctor, to get yourself diagnosed and treated.

Your doctor will perform several physical tests such as tenderness to pressure, single limb heel rise, “piano key” test for pain, and a stress examination. This could be followed by imaging tests like X-rays, MRI scan, and a CT scan to confirm the diagnosis. Depending on the severity of your injury, a treatment plan will be devised for you. If no fractures or dislocations are detected in the joint, and the ligaments are not completely torn, non-surgical treatment is usually sufficient. This involves wearing a non-weight-bearing cast for 6 weeks, and ensuring that no weight is applied upon the affected foot.

The next step in the treatment involves progress to weight-bearing with an orthotic or a removable cast boot. It is important to attend follow-up visits with your doctor during this period, for them to be able to monitor the progress of your foot through imaging tests. In some cases, these findings can indicate that the bones have been displaced, in which case you might have to undergo surgery. The surgical treatment for Lisfranc injury is recommended for injuries involving a fracture or abnormal positioning of the joints of the midfoot. This surgery aims at realigning the joints and returning the fractured bone fragments to their original positions.

The surgical options include internal fixation, in which the bones are repositioned with the help of plates or screws; and fusion, in which the damaged bones are fused together, to promote their healing as a single, solid piece. The latter is opted for incase of severe injury in which the damage cannot be repaired. Surgery must be followed by rehabilitation, in which weight-bearing is gradually reintroduced after a 6-8 week period of non-weight bearing.

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