LISFRANC'S INJURY


WHAT IS LISFRANC'S INJURY?


Lisfranc's injury or Lisfranc's fracture-dislocation is rare in sport, but if left untreated can have very severe consequences. It usually occurs in contact sports activities that require running, cutting, and jumping. It is most common seen in football, basketball and baseball when sliding into a base. Severe swelling and pain to the top of the midfoot is the most common complaint. If a case of midfoot sprain is suspected, then Lisfranc's injury should also be considered.

The term Lisfranc's joint refers to the tarsometatarsal joints where the long bones (tarsals) in the foot meet the smaller bones (metatarsals) of the toes. Jaques Lisfranc was a surgeon in Napoleon's Army who described an operation for an amputation through this joint.

WHAT ARE THE SYMPTOMS?

  • Midfoot pain with difficulty placing weight on the foot.
  • Some bone deformity, although this is not always the case.
  • Swelling on the top of the foot.
  • Tenderness on the joints.
  • Pressing the foot upwards into plantar flexion causes pain, especially if rotated at the same time.


WHAT CAN THE ATHLETE DO?

  • Go and see a doctor or sports medical professional
  • Rest,Ice,Compress,Elevate
  • Immediately offload the foot on crutches


WHAT CAN A DOCTOR OR MEDICAL PROFESSIONAL DO?

  • X-ray is required with the athlete in a weight bearing position. This injury is often missed even with an x-ray, so if the therapist suspects Lisfranc's injury and it is not obvious through X-ray then...
  • MRI, CT or Bone scan is required to confirm the diagnosis.
  • If confirmed a plaster cast with a toe plate extending under the toes is applied below the knee to immobilize the joint. Sometimes the bones require fixing with pins or wires.
  • Treatment will then depend on the severity of the injury. Precise anatomic reduction of the bones is required. If this is the case then the cast is usually on for 6-10 weeks.
  • After this time general foot and lower leg rehabilitation exercises are done to restore mobility, strength and proprioception.