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Lisfranc Sprain/Fracture/Dislocation

The Condition

The Lisfranc ligament is a very strong ligament that helps connect the long bones of the forefoot (metatarsals) to the bones of the arch (cuneiforms). This ligament helps maintain alignment of the forefoot and midfoot. Lisfranc ligament injuries can be very serious and should be evaluated immediately.

The Treatment

In order to properly treat these injuries it is necessary to determine the degree of tearing at the Lisfranc ligament. It is also important to identify associated joint dislocations in relation to the trauma. This process is completed by obtaining a thorough history and physical examination, plain film radiographs (X-rays) and advanced imaging (MRI/CT scan). Pain and swelling will undoubtedly be present. Often there will be an inability to bear weight on the injured limb.

Prompt immobilization and elevation will help reduce symptoms, but medication for pain and inflammation is typically needed. Surgery is not often indicated for isolated Lisfranc ligament sprains; however, a complete tear of the Lisfranc ligament or dislocation of the forefoot requires early surgical intervention. Your foot and ankle surgeon will determine the best treatment protocol to fit your needs.

Frequently Asked Questions

In cases of severe trauma to the foot, the most worrisome complication would be that of compartment syndrome. Compartment syndrome is a process where pressure rises in the individual compartments of the foot leading to damage of the muscular and neurovascular structures. Compartment syndrome requires emergent surgery to save the injured limb.
The most common problem that develops as a result of this injury is foot arthritis. Arthritis will require additional treatment and can present challenges as we age and the condition worsens.
When an isolated sprain injury occurs the likelihood of returning to play is very high if you have followed the guidelines set in place by your foot and ankle surgeon. In more severe cases, where surgery is required, the opportunity to return to play may be more limited and require exercise modifications for a longer period of time.
The answer depends on the severity of the injury and your overall health. Diabetic patients as well as obese patients present unique challenges that can easily alter the normal timeline for healing. Your foot and ankle surgeon will base your post-operative care on your overall health status and necessary treatments required to stabilize the Lisfranc ligament complex and joint.