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 6 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. Suring the procedure, the hardware is removed from the completely healing Lisfranc joint. The timeframe between the two stages is usually approximately 3-5 months but is left to the surgeon’s discretion. A period of immobilization and non-weight bearing restrictions are implemented following surgery for 6-8 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
The orthopedic surgeons here are also specially trained in the field of hand and wrist surgery and treat all conditions, from very straightforward to the most complex. Furthermore, we believe that even the simplest problems of the hand and wrist deserve evaluation from a hand specialist who has an expertise in understanding of the intricate anatomy of the hand.
Every patient receives an in-depth consultation to devise a treatment plan that is right for their problem. Our specialists prefer non-operative and non-invasive treatments whenever possible, including physical therapy, medications, and/or injections. When we require surgery, we will then use minimally invasive surgical techniques to fix your problem, whether it is fixing a broken bone or repairing a tendon. Our goal is always to get you back to living your life normally as soon as possible.