Lisfranc (Midfoot) Fracture
What is a Lisfranc fracture?
The Lisfranc joint is a region of the midfoot also referred to as the tarsometatarsal joints. This is normally a very stable area of the foot that sits between the metatarsals and the tarsal bones.
What causes a Lisfrac fracture?
A Lisfranc fracture can occur from a fall from height, motor vehicle accident or athletic injury.
What are the symptoms of a Lisfranc fracture?
Patients with a Lisfranc fracture typically have sudden pain after trauma accompanied by swelling and bruising and difficulty or inability to walk on the foot. Often there is a bruise on the bottom of the foot under the arch. Symptoms can initially be similar to a sprain, but will fail to improve within a few days.
How is a Lisfranc fracture diagnosed?
A thorough history and physical examination will be taken. X-rays are ordered to look for the presence of a fracture in the midfoot or gapping of the joints. A CT scan or MRI may also be ordered to provide more information.
How is a Lisfranc fracture treated?
Nonsurgical treatment
Conservative treatment may be appropriate for a Lisfrac fracture depending on the severity of the injury. This involves rest, NSAIDS, ice and elevation in order to reduce swelling and pain. Typically, a period of non-weight bearing in a splint or cast, followed by progressive weight bearing in a walking boot will be recommended.
Operative treatment
Operative treatment is recommended for displaced fractures or if the midfoot joint is not anatomically aligned. The fracture is fixed with a combination of plates and screws under general anesthesia. A tarsometatarsal fusion may also be recommended. This is followed by a period of non-weight bearing in a splint and cast or walking boot.