Lisfranc (Midfoot) Fracture

What is a Lisfranc Fracture?

Named for an 18th/19th-century French physician, Jacques Lisfranc de Saint-Martin, a Lisfranc fracture involves the group of bones that form the arch between the ankle and toes. An injury or accident can cause them to break.

What are the symptoms of a Lisfranc fracture?

Often mistaken for a sprain, a Lisfranc fracture causes the top of the foot to swell and be painful. If rest, ice and elevation do not reduce the pain and swelling within a day or two, the patient may have a fracture.

Who is likely to get a Lisfranc fracture?

The physicians at Midwest Orthopaedics at Rush often see football or soccer players with a Lisfranc fracture. This is because of the twists and turns these athletes use to play their sport. But, anyone can get a Lisfranc fracture as a result of an accident. Victims of motor vehicle accidents can get a Lisfranc fracture.

What causes a Lisfranc fracture?

A Lisfranc fracture typically occurs when a patient drops something on the foot, twists the foot or uses the foot as a brace during a car accident.

How is a Lisfranc fracture diagnosed?

During the examination at one of the clinics at Midwest Orthopaedics at Rush — with locations in Chicago, Westchester, Oak Park and Winfield, the physician rotates the patient's foot. If this results in severe pain, it may be a fracture. The foot and ankle doctor may also check for bruising on the bottom of the foot, which is another sign that bones are broken.

Diagnosis can be difficult, though, because a Lisfranc injury is hard to see on an X-ray. The physician may also order a CT scan or MRI.

Undiagnosed, a Lisfranc fracture can lead to joint degeneration or compartment syndrome, which is a build-up of pressure within muscles that can result in damaged nerve cells and blood vessels.

What are the treatments for a Lisfranc fracture?

Non-surgical Treatment Options

A simple Lisfranc fracture does not necessarily require surgery. The patient may have to wear an immobilizing boot for four to six weeks until the foot heals. Pain is controlled with ice and anti-inflammatories.

Surgical Treatment Options

If the fracture forces the bones out of position, the foot and ankle physicians at Midwest Orthopaedics at Rush may perform surgery. They use plates and screws to stabilize the bones. In extreme cases, the surgeon must fuse the bones together.

After surgery, patients wear a cast and stay off their feet for about eight to ten weeks. For another four to six weeks, a patient will wear a rigid arch support or walking boot while the foot continues to heal. Even with surgery, a Lisfranc fracture increases the patient's chances of getting arthritis later in life. If the patient doesn't have fusion surgery after the injury, it might be required later down the road.