This book describes Lisfranc Foot Injury, Diagnosis and Treatment and Related Diseases

A Lisfranc injury happens when there are either torn ligaments or broken bones in the mid-foot region of one or both feet.

The mid-foot is the region of the foot that forms the arch, where the forefoot (bones of the toes) and hind-foot (bones including the ankle and heel bone) connect.

The Lisfranc joint complex involves the bones and ligaments that attach the mid-foot and forefoot.

Lisfranc injuries involve ligament strains and tears, and fractures and dislocations of bone

The mid-foot is important in stabilizing the arch and in walking (gait).

During walking, the mid-foot transmits the forces produced by the calf muscles to the front of the foot.

The mid-foot joint complex is also termed the Lisfranc joint.

The mid-foot comprises the Lisfranc joint and the Lisfranc ligament, both of which can be injured in a Lisfranc injury.

These injuries are among the most frequent foot injuries.

They vary from mild to severe, dependent on how the injury happened.

Lisfranc injuries happen if ligaments that support the mid-foot are torn or bones in the mid-foot are broken.

The seriousness of the injury can vary from simple to complex, involving many joints and bones in the mid-foot.

A Lisfranc injury is often incorrectly diagnosed as a simple sprain, particularly if the injury is a result of a straightforward twist and fall.

The injury to the Lisfranc joint is not a simple sprain that can be simply "walked off."

It is a severe injury that may take many months to heal and may need surgery to treat.

Causes

A range of injuries can lead to a Lisfranc fracture.

This injury most often happens when the patient twists the foot while falling.

These injuries can happen with just a twist and fall.

This is a low-energy injury.

It is often visualized in football and soccer players.

It is often observed when someone stumbles over the top of a foot flexed downwards.

More serious injuries happen from direct trauma, such as a fall from a height.

These high-energy injuries can cause multiple fractures and dislocations of the joints.

If the foot is crushed or injured while flexed, the patient may also have this fracture.

This normally produces a mild injury.

The direct trauma can produce an even more serious form of the fracture.

Falling from a great height has been found to produce Lisfranc fractures that need extensive treatment.

The most frequent symptoms of Lisfranc injury are:
1. The top of foot may be swollen and painful.
2. There may be bruising on both the top and bottom of the foot.
3. Bruising on the bottom of the foot is highly indicative of a Lisfranc injury.
4. Pain that becomes worse with standing, walking or trying to push off on the affected foot.
5. The pain can be so serious that crutches may be needed.

If standard treatment for a sprain (rest, ice, elevation) does not alleviate pain and swelling, the patient should consult an orthopedic surgeon

An x-ray also can reveal the alignment of the Lisfranc joint and the presence of fractures.

A mild Lisfranc fracture can often be treated the same way as a simple sprain with ice, rest, and by raising the injured foot.

If there are no fractures or dislocations in the joint and the ligaments are not totally torn, non-surgical treatment may be all that is required for healing.

A non-surgical treatment plan involves wearing a non-weight bearing cast or boot for 6 weeks.

Surgery is advised for all injuries with a fracture in the joints...