Fancy name....potentially a bad problem. If you hear of an athlete having a season ending foot injury, here is a good chance that the Lisfranc Joint is involved. A specific type of 5th metatarsal fracture could also be the culprit.
This is a really informative video about the injury:
What is this fancy sounding injury?
Lisfranc injury is a complex foot injury that occurs when there are either torn ligaments or broken bones in the midfoot area of the foot. The Lisfranc joint is the spot on top of your foot where the metatarsal bones (long, skinny bones in your foot) connect to the rest of your foot. This is a complicated area of your foot, where many bones, ligaments, and tendons all come together to hold your foot’s arch in shape and help it move properly.
How is it injured?
I have almost exclusively seen this injury in football, but it can happen in many other sports.
The most common causes of a Lisfranc injury include:
Twisting your foot while falling.
Crushing or damaging your foot while flexed such as the weight of a defender on the foot while being tackled.
Direct trauma, such as falling from a great height. This is usually not a sports related injury in this instance.
What are the symptoms?
The symptoms of a Lisfranc injury depend on the severity of the injury. Common symptoms include tenderness and swelling at the site of injury and the top of your foot. You may also have pain that gets worse when you walk or stand. Bruising can occur on both the top and bottom of your foot as well. Bruising on the bottom of your foot is the strongest indication that you have a Lisfranc fracture, and not a sprain. Please have your athlete's foot thoroughly evaluated if they have any of these symptoms. A missed Lisfranc injury can be a big issue down the road.
It’s important to get your injury examined by a healthcare provider as soon as possible. This will ensure you know exactly what’s wrong and which treatments will help you heal. Like any bone fracture, the severity of the original injury and any damage done to your bones makes each Lisfranc injury unique.
How long will the athlete need to recover?
The biggest bummer with Lisfranc Injuries is that it takes a long time to recover. You just have to accept the fact that your kid will most likely miss his or her entire competitive season following this injury.
The recovery time for a Lisfranc fracture varies depending on the severity of the injury. A mild Lisfranc fracture can often be treated the same way as a simple sprain — with ice, rest, and by elevating the injured foot. More severe injuries might require you to wear a cast for up to six weeks. Most people need to wear a cast or boot for 6 to 12 weeks, and it can take a year or more to return to intense exercise like running.
The most severe versions of this injury will require a surgical procedure to fix and stabilize the joint. The goal of surgery is to realign bones and repair ligament tears. There are two primary types of Lisfranc injury surgery: internal fixation and fusion. Internal fixation involves using screws, wires, or pins to stabilize the fracture. Fusion surgery is less common than internal fixation. It involves fusing the bones together with plates and screws. Here is really cool animation that shows a version of the surgical procedure.
Physical therapy can help your athlete regain strength and range of motion in your foot following adequate healing time. A Physical Therapist or Athletic Trainer can also work with you to provide other ways to stay active during the rest and recovery process.
Takeaways......
This is a significant injury. Be patient, be supportive and give your kid compassion and love. They will need it through the recovery process. Make sure your athlete is compliant during the recovery to ensure proper healing and a full return to sport. If treated the right way, they will be back to previous levels of competition.
Hunter Greene, MS, ATC, OPA-C
**Disclaimer: Please consult with a local healthcare professional for definitive diagnosis and treatment. This information should not be used to diagnose and treat injuries.
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