LisFranc Fracture/Dislocation
Dr. Stephen Brigido
The LisFranc region of the foot, named after a general in Napoleon’s army; is the part of the foot where the metatarsals meet the midfoot. At this level there is a network of ligaments that are extremely important to the stability of the foot.
What causes LisFranc fracture/dislocation?
Injuries to this region typically occur in motor vehicle accidents, military injuries, athletes, horseback riders, or something as simple as a mis-step off of a curb. These are of the WORST foot and ankle injuries.
What are the symptoms of LisFranc fracture/dislocation?
Patients present to the emergency room or office with an extremely swollen and bruised foot. These patients will have pain when standing and often are unable to bear weight on the affected foot. Some patients will describe a foot that appears wider than normal or has a prominent bone on the inside of the foot. There are three types of LisFranc injuries. The Sprain occurs when the ligament that attaches the medial cuneiform to the base of the second metarsal is stretched or partially torn. This causes instability to the midfoot and pain. LisFranc Fractures occur when there is a break in the bone in the LisFranc joint complex. These can be small avulsion fracture (a flec of bone is broken) or they can be complex involving multiple bones. The LisFranc Dislocation occurs when the ligment complex to the midfoot is damaged to the point where the bones shift position.
How is Lis Franc fracture/dislocation evaluated?
Diagnosis is made with x-rays, MRI’s, and CAT scans.
What are the treatment options for Lis Franc fracture/dislocations?
While non-surgical treatment of the LisFranc injury is less common, a combination of immobilization, oral medications, and physical therapy can be beneficial depending on the severity of your injury. In most cases, treatment of LisFranc injuries are surgical in nature, requiring the surgeon to place pins, screws, and/or plates across the fractured/dislocated bones and joints.
What can I expect after undergoing successful treatment for Lis Franc dislocation/fracture?
While surgical treatment is often very successful, these patients often have a difficult time returning to high level athletics. 90% of patients who sustain a LisFranc dislocation will develop some degree of arthritis in the region of the injury that will often require medical attention.