Lisfranc (Midfoot) Injury
Midfoot injuries occur if the bones in the midfoot are broken, or the ligaments that support the area is torn. The injury can range from simple to complex. This type of injury is often mistaken for a sprain. However, these injuries can’t be treated in the same way and may require surgery, therapy and other treatment to heal properly.
The midfoot, or lisfranc, is found in the middle region of the foot. There is a cluster of small bones that form an arch to the top of the foot. The bones are held in place by connective tissues that reach out across and down the foot. The midfoot stabilizes the arch. As you walk the midfoot transfers the forces formed by the calf to the front of the foot. The midfoot joint is refered to as the Lisfranc joint, and is named after French surgeon Jacques LIsfrac de St. Martin.
If the bones or ligaments in the midfoot are damaged serious consequences can occur. Injuries can affect one joint, or be more complex and disrupt multiple joints and bones. Lisfranc injuries typically damage the cartilage of the midfoot joints. Cartilage allows the joints to move smoothly and covers the ends of the bones. If severe midfoot injuries are ignored damage can be done to the cartilage that lead to flatfoot and arthritis.
These injuries can occur with a simple fall. It’s common among athletes and is often seen when someone stumbles over the top of their downward flexed foot. A fall from a height can lead to more severe injuries and result in multiple fractures and dislocations.
In most cases, the top of a patient’s foot may be swollen and sore. There may also be bruising on both the top and bottom of the foot. Pain increases with standing and walking, and sometimes crutches may be needed.
Treatment for midfoot injuries depends on the severity of the damage. If there are no fractures or dislocations in the joint or no tears in the ligament nonsurgical treatment is recommended. This includes wearing a non-weight bearing cast for six weeks. In time patients can wear weight bearing removable cast boots.
Surgery is recommended for injuries where there is a fracture in the joints of the midfoot or a strange positioning of the joints. Surgical treatment realigns the joints and returns the bone fragments to a normal position.
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