The surgical repair of an injury to the midfoot where the Lisfranc joint complex is found.
A Lisfranc injury is an injury of the midfoot that involves either a break to the bones and/or a strain to the ligaments that connect the midfoot to the forefoot. Nonsurgical treatment is always the goal and can sometimes be achieved if the injury is not severe and in the absence of fractures, joint dislocations or complete ligamentous tears. A cast or boot would be applied and a strict non-weight bearing regimen for six weeks (or longer) would be enacted to allow proper healing. However, in most cases, this injury requires surgical repair where a fracture is present or subluxation (abnormal positioning) of the joint has occurred. This surgery is performed in two steps: the first step is the ORIF (open reduction with internal fixation) of the injured joint space with special plates and screws. Because the hardware is placed across a joint, a joint which requires motion once healed, a second operation (stage 2) is necessary. During the procedure, the hardware is removed from the completely healed Lisfranc joint. The timeframe between the two stages is usually approximately three to five months but is left to the surgeon’s discretion. A period of immobilization and non-weight bearing restrictions are implemented following surgery for six to eight weeks. Once your surgeon has determined that the injury is more stable, he or she will allow a gradual increase in weight bearing and physical therapy exercises to regain mobility and functionality of the joint. Impact activities, such as jumping or running, must be avoided until the second stage is complete and the hardware is removed. Unfortunately, post-traumatic arthritis is a very common long-term effect from this injury, even with efficient surgical fixation, and may require further treatment in the future.
Schematic of Lisfranc Joint Complex
Various methods of ORIFs used to repair Lisfranc injuries
Our world-class orthopedic surgeons have years of experience treating foot and ankle conditions. We believe that even the simplest problems should be evaluated by a specialist.
As our patient, you will have an in-depth consultation with one of our doctors. We will create an individualized treatment plan together, tailored to your problem and lifestyle. Our doctors prefer non-invasive treatments whenever possible, including physical therapy and/or injections. If your problem ultimately does require surgery, our doctors prefer the least invasive surgical techniques possible. Our goals are the same as yours: to get you back to living your best life, pain free.