The Hazards Of A Lisfranc Injury


By Brett Sachs, DPM

You were playing football in the backyard and your 6-foot-4 cousin landed hard on your foot as he came down with the ball. Ouch! Now you can hardly stand to put weight on it. What do you do?

Listen to your body! If it hurts, something is wrong. It could be a bruise or an ankle sprain, but it could also be a Lisfranc injury that needs immediate attention so it doesn’t seriously harm your foot. Turn to the experts at Rocky Mountain Foot & Ankle Center to get to the bottom of your pain.

What Is a Lisfranc Injury?

Your have 26 bones in your feet that allow the intricate movements needed for walking and running efficiently. The connections between the tarsal bones at the back of your foot and the long metatarsal bones of your midfoot make up the Lisfranc joint. There are three different injuries that can occur in this area:

  • A sprain occurs when the Lisfranc ligament (or others around the joint) are stretched too far or torn, causing instability and the inability to support your arch structure.

  • A fracture is when a chip breaks off the bone (avulsion), or one or more of the metatarsals breaks. We may need to take X-rays to determine the extent of the damage.

  • The bones may be dislocated and not able to move back on their own.

What Will the Injury Feel Like?

The area will likely swell quite soon after it happens. Your midfoot will hurt when you put weight on it—in fact, you may not be able to stand on it at all. If the bones are out of position, the foot may look wider than normal. The area on top of your feet ahead of your ankle may bruise, and bruising or blisters can appear under the arch as well. This last sign is a good indication that a Lisfranc injury has occurred.

It is crucial that you do not ignore these symptoms. This injury can have some serious complications, including compartment syndrome, when pressure builds up in the tissues which could damage your muscles, nerves, and blood vessels. If this happens, you will need surgical treatment as soon as possible to avoid serious problems in your foot.

The site may also develop arthritis months later. Your best bet to head this off will be to make sure the injury is fully and properly healed, and that will require expert diagnosis and treatment.

Will I Need Surgery?

There are many conservative treatments for mild Lisfranc injuries, including immobilization, RICE (Rest, Ice, Compression, and Elevation) therapy, oral medication for pain and swelling, and physical therapy to restore full function to your foot. However, surgery is usually the best answer for fractured bones and dislocations in the midfoot. There is so much stress on your arch with every step that the stability of the bones in these joints is necessary.

There are a variety of ways to fix broken bones in your foot, and Dr. Matthew Paden, Dr. Brett D. Sachs, and Dr. Dustin Kruse are expert at these procedures. Screws and plates will be used to hold the bones and joints in place while they and surrounding tissues heal. The hardware may be removed later, to allow movement in the bones.

When the joints or ligaments are severely damaged, they may need to be permanently fused together to heal in a solid mass. In this case the hardware will not be removed, because the joints will no longer move. We will thoroughly examine and diagnose your injury and explain the procedure that will bring the best outcome for you.

Following surgery, there will be a recovery period, and then physical therapy once healing has taken place. Following through with this is key to restoring full function to your foot.

If you have injured your midfoot, don’t wait. Call Rocky Mountain Foot & Ankle Center in Wheat Ridge or Golden, CO, at (303) 423-2520 to set up an appointment. If it is a Lisfranc injury, you will appreciate our excellent podiatric care and surgical experience. We treat your feet right, so you can get back to your full and active life.

Photo credit: rimkaitis via

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