Does a Lisfranc Injury Require Surgery?
In cases where there is no fracture and ligament damage is minimal, non-surgical/conservative treatment measures are often effective in healing the injury. We will most likely prescribe a cast or boot to wear on the injured foot for a few weeks to allow the injury to heal. Additional X-rays will be taken during follow-up appointments to evaluate how the injury is healing. Following a period of immobilization weight is reintroduced to the foot in a gradual fashion (Weight Progression Instructions). Following this transition patients typically work back into regular shoes. Physical therapy may help with returning to higher function.
What is the Surgical Treatment for a Lisfranc Injury?
If a displaced fracture the midfoot region or if subluxation/dislocation of the midfoot joints has occurred, then surgery may be recommended. The goal is to realign the joints and return the bones to their normal, functioning position.
Through incisions on the top of the foot, the Lisfranc region will be visualized. To correct the damaged area internal fixation involving hardware such as plates, screws, or heavy suture are often used.
For fractures, the bone is directly manipulated into a normal position and fixation applied. For ligamentous injury, the bones are reduced and held in place with sutures, screws or a plate over the joint. Rigid fixation (plates or screws) are often removed about 4 months after injury.
In more complex injuries where fixation will not be enough to correct the damage, a fusion of the affected joints may be indicated. With a fusion the bones involved will grow together, eliminating the joint but providing a stable and pain free midfoot.
What happens after Lisfranc Treatment?
It is essential that patients follow the post-operative protocol for recovery as set forth by the surgeon as it remains a crucial part of the healing process. Regardless of the surgery that has been performed to correct a Lisfranc injury, the healing process can be lengthy. A cast or boot will be required for four to eight weeks following surgery. While most will recover fully from this injury, it is important to note that some athletes will not be able to return to their pre-injury level of competition. Each case is different and our goal is always to obtain the best possible outcome for each patient.